The Pro Second Amendment Committee

Membership/Renewal Form

For PSAC Use Only

Banquet	$
Dues	$
Contribution	$

Date_________ Ck#______

    NAME:_______________________________________________________

    ADDRESS:____________________________________________________

    CITY:__________________________ STATE:_____ ZIP:____________

    PHONE: HOME____________________ WORK________________________

    FAX: ___________________ E-MAIL:____________________________

Your contact information will be used only for communications with the membership that concern the organization's business or purpose (e.g., meeting notices, legislative alerts).

Annual Membership is $30.00 per family. Please list other family members below. School age members are eligible to enter the annual essay contest for cash and prizes.

One free T-shirt with first-time membership.

Mail to:

Pro Second Amendment Committee
P. O. Box 40191
Grand Junction, CO 81504

For more information:

Call 970-434-7745
www.prosecond.org

T-Shirt

Current members may also obtain T-shirts for $14 each. Call the number above for sizes in stock and to order.