MEMBERSHIP FORM

( ) $25.00 Individual                    ( ) Former UNMLA Member
( ) $30.00 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:

Jason Gesch    925 Charleston St.    Lincoln, NE  68508