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region #1 report - Safari Club International Northwest Chapter

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Membership Application<br />

SAFARI CLUB INTERNATIONAL<br />

NORTHWEST CHAPTER<br />

__________________________________________________________________________________<br />

NAME SPOUSE’S NAME<br />

___________________________________________________________________________________<br />

HOME ADDRESS CITY / STATE / ZIP COCE<br />

__________________________________________________________________________________<br />

BUSINESS ADDRESS / COMPANY NAME CITY / STATE / ZIP CODE<br />

_______________________________________ ______________________________________<br />

HOME PHONE BUSINESS PHONE<br />

_____________________________________ ______________________________________<br />

CELL PHONE FAX<br />

_______________________________________ ______________________________________<br />

DATE OF BIRTH EMAIL<br />

. Please check the address you prefer club notices be sent to: __ Home Address __ Business Address<br />

Name, as it should appear on SCI Name Badge ______________________________________________<br />

Vocation or Profession _________________________________________________________________<br />

We promote the freedom to hunt and wildlife conservation worldwide. We do this through quarterly<br />

newsletters, meeting with programs of interest, conservation and hunter education programs, public programs,<br />

family events, and an annual fund raising banquet. We are successful in these endeavors because we are an<br />

active club with active members. As a member of the <strong>Northwest</strong> <strong>Chapter</strong>, I am interested in helping in the<br />

following areas:<br />

Please check all that apply<br />

__ <strong>Chapter</strong> Meetings __ Membership __ Trophy Records & Awards<br />

__ Officer or Director __ Education __ Conservation Projects<br />

__ Youth Hunt __ Newsletter __ Sportsmen Against Hunger<br />

__ Fundraising __ Hunter’s Rights __ Publicity & Advertising<br />

To join our chapter, please: 1) fill out and sign this application, 2) obtain a club member’s sponsor, 3) mail a check<br />

for the first year’s dues payable to “<strong>Safari</strong> <strong>Club</strong> <strong>International</strong>” and mail to the membership chairman shown below.<br />

<strong>Safari</strong> <strong>Club</strong> offers Individual Memberships for $110 ($55 National + $55 <strong>Chapter</strong>) and Family Memberships for $130<br />

($75 National and $55 <strong>Chapter</strong>) which extends membership status to spouse and children under age 18.<br />

__ I am applying for Individual Membership: ($110 due with application)<br />

__ I am applying for Family Membership: ($130 due with application)<br />

__ I am applying for <strong>Chapter</strong> Membership: ($55 due, must also be a National member)<br />

__ I am applying for <strong>Chapter</strong> Life Membership: ($1000 due, must also be a National member)<br />

______________________________________________________________________________________________________________________<br />

SIGNED SPONSOR DATE<br />

Please mail your application and check to the Membership Chairman:<br />

SCI – NW <strong>Chapter</strong>, Mike Rex, 1924 Lighthouse Lane NE, Tacoma, WA 98422<br />

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