Please PRINT OUT This Application Form, Fill It Out, and Mail It To The Address Below:

Maine Gun Owners Association Inc

Individual Membership Application

Circle: New or Renewal <> Membership Class (Please Circle One Below):

Annual-$10 <> Life-$300

First Name _______________ MI ____ Last Name _______________________

Mailing Address: __________________________________________________

City/Town: ______________________________ State ______ Zip __________

Phone Number: (_____) _____-_________ Age:_______

E-mail Address: __________________________________________________

MGOA has compiled an Electronic Mail List as a communications tool to keep its membership informed about upcoming events and urgent issues of interest. Would you like to be added to this list? Please Circle: YES NO

Are you interested in working on an MGOA committee? Please Circle: YES NO

The Maine Gun Owners Association Pledge:

I certify that I am a citizen of the United States; that I am not a member of any organization which has as any part of its program the attempt to overthrow the government of the United States by force of violence; that I have never been convicted of a crime of violence, and that if admitted to membership I will fulfill the obligations of good citizenship.

Signature of Applicant ______________________________ Date: ___________

Please make check payable to "Maine Gun Owners Association Inc" and mail with this Application Form to:

Please Mail This Completed Application Along With The Appropriate Payment To:

MGOA

ATTN: Jeff Weinstein, President

PO Box 373

Yarmouth ME 04096

Any Questions? Please Call 207-846-3000

Allow Approximately Three-Weeks For Processing....Thanks!

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