MEMBERSHIP FORM

( ) $20.00 Individual                    ( ) Former UNMLA Member
( ) $25.00 Family                          ( ) New Member
                                                       ( ) New Address

NAME ___________________________________________________________

ADDRESS ________________________________________________________

CITY ____________________ STATE _________ ZIP ____________________

PHONE __________________________________________________________

CLUB AFFILIATION (IF ANY) ______________________________________

DO YOU BELONG TO THE NRA ? ______ # _________________________

DO YOU BELONG TO THE NMLRA ? ______ # ______________________

Checks should be made out to read UNMLA, and sent to:

Ron Knott
321 Knott Ave
Grand Island, NE   68801