PENNSYLVANIA LONGBOW ASSOCIATION
                                                                                                                               MEMBERSHIP APPLICATION

                                                                                                                                 Please check appropriate box

NAME_________________________________________________          [   ]    New    [    ]   Renewal

 ADDRESS______________________________________________          [    ]    Family.............…..$30.00


                    ___________________________________________          [    ]    Individual(18-65).........….$20.00

 PHONE #_______________________________________________        [    ]    Sr. Citizen (65+)....$ 10.00

 EMAIL ADDRESS  ______________________________________         [    ]    Student (17 or less)$ 5.00

 BIRTH DATE____________________________________________

 Make checks payable to: PA LONGBOW ASSOCIATION

Mail to:
Bess Ellen Criswell– Secretary
1288 S. Mountain Rd.
Dillsburg, PA 17019


(Parent & Children<18)