Check one: _____New _____Renewal

_____Individual Membership (with Trappers Post Magazine) $25.00

_____Individual Membership (w/out Trappers Post Magazine) $16.00

_____Junior Membership--16 & under (w/ Trappers Post Magazine) $14.00

_____Junior Membership (w/out Trappers Post Magazine) $10.00

_____Life Membership $200.00

___Installments of $25.00 per month

___Installments-$25.00 e/other month

Name: _________________________

Address: _______________________

City___________________________

State / Zip: _____________________

County of Residence: ______________

Telephone: ______________________

Birthdate: _______________________

Names & birthdates of other family members

(For Family Membership)

_______________________________

_______________________________

_______________________________

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