National Rifle Association of America
Membership Application
Please fill out and mail this form to the NRA address indicated at the bottom of the page.
 
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NRA Recruiter: George Gulick
Recruiter ID: XR017084
Member Information: 
___New Member   ___Renewal   NRA ID#(renewals only): __ __ __ __ __ __ __ __ __
Name:_______________________________________________________________
Address:____________________________________________________________
City/Prov:______________________________ State: _____ ZIP: ________  Country _________
Daytime phone: (____) _______________   Birthdate: ___/___/___    Today's Date: ___/___/___
Foreign members will be subject to additional postage charges. See 'Amount Due' section below.
 
Term/Type of Membership: 
Adult (18 and over):  ___1 year($35 $25___2 year($60)  ___3 year($85)  ___5 year($125)
Junior (under 18):  ___1 year w/Insights Newsletter($15)  ___1 year w/Mag choice($30)
Distinguished (65+ or Disabled Veteran):  ___1 year($30)
Easy Pay Life ($25 first month payment due immediately followed by quarterly payments of $25): 
  ___ Regular (30 payments)   ___ Junior (22 pmts)   ___ Senior/Distinguished (15 pmts) 
 
Life Membership:  ___ Regular($750)  ___ Junior($550)  ___Senior/Distinguished*($375)
      *Distinguished Life Membership is available for age 65+ or Disabled Veteran.
 
Magazine Choice:   ___American Rifleman  ___American Hunter  ___America's First Freedom  ___Women's Outlook
 
Payment Amounts: 
Membership Dues                                 $________
Second Magazine ($15/year)                      $________
Foreign Postage (per year) Canada $5, Other $10 $________
Total Amount                                    $________
Membership dues paid to the National Rifle Association of America are not refundable or transferable and are not deductible as charitable contributions for Federal income tax purposes. Three dollars and seventy five cents of the membership dues are designated for magazine subscription.
 
Payment Information: 
___ Check or Money Order (payable to National Rifle Association)
___ Charge to    ___MasterCard  ___Visa  ___Discover    ___American Express
Account #:  __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __  Exp. __ __/__ __
  
Signature (credit card only):_____________________________________
 
 Mail application and payment to:  National Rifle Association of America, Recruiting Programs Department,  
 11250 Waples Mill Road, Fairfax VA 22030