Join or Renew on-line using PayPal secure site: Join On-Line

DATE:__________________                       NEW:___  RENEWAL: ___ 

NOTE:  PPFC Membership runs for a calendar year, prorated semiannually:
	(Members joining in December will pay for next year only.)

TYPE
Date joining
Dec-Jun
Jul-Nov
Individual
$20
$10
Family
$30
$15
Patron*
$500
$250
*Patron members will receive a plaque and recognition in newsletter
     when they pay for a full year.

Please indicate the membership type and amount submitted:

    ___ Individual $______
    ___ Family $_______
    ___ Patron $_______

ADDITIONAL CONTRIBUTION(S):

    Help with Newsletter Expense $_________

    Billboard Fund $_________

    VFW Hall Rental $________ ($30 per month)

    For General Expenses $___________


NAME:______________________________________________________________
            (First)        (Middle or Initial)        (Last)

E-MAIL ADDRESS:______________________________________

STREET (or P. O. Box):_____________________________________________

CITY:____________________________  STATE:_____  ZIP:_______________

HOME PHONE: (____)______________   WORK PHONE: (____)______________

FAX PHONE: (____)________________

NOTE: The Pikes Peak Firearms Coalition seeks to influence
legislation and, as such, dues and contributions are not tax
deductible as a charitable contribution under IRS rules.

Mail application to:	Pikes Peak Firearms Coalition
			PO Box 17253
			Colorado Springs, CO 80935-7253

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