FLORIDA SPORT SHOOTING ASSOCIATION
Individual Membership Application
FIRST NAME M..I.. LAST NAME
ADDRESS APT
CITY STATE ZIP + 4
PHONE # EMAIL
BIRTH DATE ARE YOU MEMBER OF THE NRA? USA SHOOTING ?
MEMBERSHIP CATEGORIES
LIFE ___$300.00 ANNUAL___$20.00 JUNIOR___$7.5O
6 YEAR MEMBERSHIP _____$100.00
PAYMENT METHOD
VISA MASTERCARD DISCOVER CARD AMERICAN EXPRESS
CARD NUMBER EXPIRATION DATE (MO/YR)
SECURITY CODE Generally 3 # on back of card
FSSA NEWSPAPER -MIXED CALIBERS
MAILED TO YOUR HOME (4 TIMES A YEAR) DOWNLOADED FROM FSSA WEB SITE
SPONSORED BY (Optional)