10/21/2020
TOP SHELF SPORTSMAN AND CONSERVATION CLUB, INC.
MEMBERSHIP APPLICATION (COPY/PRINT - MAIL P.O. BOX 51893, SARASOTA, FL. 34232 OR EMAIL: [email protected])
NAME:_______________________________________________________________
STREET ADDRESS:___________________________________________________________
CITY:___________________________ STATE______________ ZIP ____________
HOME PHONE:______________________CELL PHONE:_____________________________
EMAIL ADDRESS:______________________________________
DOB:_______________________
OCCUPATION:_______________________
BACKGROUND CHECK REQUIRED: _____ YES ______ NO
COPY OF CARRY CONCEAL SUBMITTED:______ YES ______ NO
CARRY CONCEL LICENSE NUMBER:______________________
MEMBERSHIP FEE:
Adult Membership $50.00
Junior Membership (17 and under) $10.00 (with a parent membership)
(Must be accompanied by responsible adult at all times)
_____ CREDIT CARD
_____ CHECK (made payable to “Top Shelf Sportsman and Conservation Club, Inc.” P.O. Box 51893, Sarasota, Florida 34232)
TOP SHELF SPORTSMAN AND CONSERVATION CLUB, INC. IS A 501(c)(3) Company
**Dues will be due each year following initial membership as a membership dues
_____________________________________________________________________
I understand there are no refunds or returns of membership dues or fees after becoming a member. All members under this membership will always abide by said bylaws.
Signature:______________________________________________ Date:_______________
Parent/Guardian (if under 18) _____________________________ Date:________________
“A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.” FDACS's toll-free number is 1-800-HELP-FLA (435-7352)
Dues Payable on PayPal: www.PayPal.com Send Payment To: [email protected]
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10/21/2020