Membership Application

Scottsdale Sportsman's Club
Membership Application

Dues:	$17.00	Individual	[_]	Membership runs from June 1 through May 30 each year.
	$24.50	Family	[_]	Membership runs from June 1 through May 30 each year.

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                     Primary Members Name

            Home Phone

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                          Street Address

                 City, State ZIP

            Business Phone

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                          Occupation

                 E-mail address

            Fax number

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           Name of Spouse (if family membership)

I certify that I am a citizen of the United States of America and that I am not a member of any organization or group which has any part of its program the attempt to overthrow the Government of the United States or any of its political subdivisions by force or violence: that I have never been convicted of a crime of violence, and, if admitted to membership, I will faithfully endeavor to fulfill the obligations of good sportsmanship and good citizenship.

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Primary Members Signature		Date

Mail completed application with check or money made payable to:

Scottsdale Sportsman's Club
P.O. Box 1432
Scottsdale, AZ 85252

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Primary Members Name		Home Phone

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Street Address	City, State ZIP	Business Phone

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Occupation	E-mail address	Fax number

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Name of Spouse (if family membership)