Fillable SLCFSA MEMBERSHIP FORM Payable to SLCFSA

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SLCFSA MEMBERSHIP FORM Payable to SLCFSA

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MEMBER # __________ YEAR ____________ GATE CARD # ____________
Check One: Renewal New Member
SLCFSA MEMBERSHIP FORM
Renewal $75. New $100
Payable to SLCFSA
Renewal form with payment must be submitted in person
at a General Membership meeting or mailed with a postmark
by Dec. 31. Mail to P.O. Box 534, Quarryville, PA 17566
New Member form with payment must be submitted in
person at time of New Member Orientation. Picture ID required.
Renewals include member #, applicable year & gate card # at the top of page.
NEW MEMBERS, DO NOT MAIL FORM OR PAYMENT, MUST BE SUBMITTED IN PERSON
(New members leave member #, year and gate card # blank. Filled out at orientation)
On the date of submitting this form and signing this Release of Liability I am stating that I am 18 years of age or older and that I agree to
adhere to the SLCFSA Constitution and Bylaws, its Policies, Procedures and Activity-Specific Standards of Procedure
Please print legibly, date and sign the Release of Liability waiver and provide the information below.
NAME _________________________________________________________________________________________________
Last First M.I.
MAILING ADDRESS _______________________________________________________________________________________
CITY ____________________________________ STATE _______ ZIP __________ PHONE # (_____) ________________
GENDER: M F DOB ___________ EMAIL ________________________________________________________
-Newsletters are posted on the club website in the Members Only section. Choose ONE mode of receiving the newsletter
Website Email Mail via USPS
-Choose whether to receive SCLFSA email containing club information. Yes No
- “FR” ACTIVE MILITARY/ FIRST RESPONDER/ LAW ENFORCEMENT/ GCO/ FCO. Yes No AGENCY____________________
Payment by check or money order ONLY, payable to: SLCFSA. $75 Renewal / $100 New Member.
Renewal with pin mailed to you $77. Returned check fee $25. Lost gate card $25
Rev. 8-15-2021
~ MEMBERSHIP FORM INSTRUCTIONS ~
THIS FORM MUST BE SUBMITTED EACH YEAR BY ALL MEMBERS BY DECEMBER 31
ST
Postmarked or in person at a General Membership Meeting by 12/31
Please fill out the entire form legibly. The form online has fillable fields, sign after printing (no electronic/digital signatures)
1. MEMBERSHIP NUMBER is assigned to you when you join, keep a record of that number.
2. YEAR-Enter the year for which the renewal applies. New Members the year will be filled out at orientation.
3. GATE CARD NUMBER is the card manufacturer number printed on the edge of the RFID card that is issued to you fo
r
a
ccess at the main gate. New Members will be issued a gate card at orientation. NO access until voted in.
4. PROOF OF MEMBERSHIP- Is a combination of your member number, name and gate card number.
-Using USPS to receive the newsletter. Your member number is the numbers before you name on the newsletter
mailing label. From the mailing label cut and clear tape the year, your member number and name to your gate card.
Y
our gate card with the mailing label attached is your proof of membership.
-Using the website or email to receive the newsletter. Your member number is not included when receiving
newsletters via the website or email. Your proof of membership is obtained by logging on to your account on the
SLCFSA website, go to “My Account”, print the section of the page that shows the year, your member number and
name, cut and clear tape the year, your member number and name to your gate card. This is your proof o
f
membership. The website is maintained so that only current members have access to the “Members Only” section.
5. RELEASE OF LIABILTY WAIVER. DATE and SIGN. This protects the club and its members.
6. CONTACT INFORMATION.
USPS-Your name and mailing address are used to send the newsletter if you select “Mail via USPS”.
Phone-Your phone number is for internal club related use only.
Email- a) For receiving the newsletter if you select “Email”. b) For club notifications such as requests for voluntee
r
h
elp and important announcements, if you select “yes” to receive this type of email.
7. “FR”-ACTIVE MILITARY/ FIRST RESPONDER/ LAW ENFORCEMENT/ GCO/ FCO renewals. If your New Member
Orientation date was June 30
th
or prior, you must include dues with your renewal. If your New Member
Orientation date was July 1
st
or later you only submit your renewal form. Your dues for the following year
are paid. You can pay $2 for a pin to be mailed to you or receive one free at a monthly membership meeting
8. PAYMENT-Make your check or money order payable to SLCFSA. Cash not accepted.
Make your payment for the following amounts only:
Club Pin only- $2. Mailing fee. This is exclusively for Honorary Members and some FR’s (see 7. above)
Renewal only- $75.
Renewal and pin- $77. The extra $2 is to have a pin mailed to you. Pins are free at meetings and orientation.
New Member- $100. In person, with form and picture ID at orientation. DO NOT MAIL.
(New Members will be issued a pin at orientation with no additional fee)
Donations-Please submit a separate payment. Thank you to all who have donated!
One check or money order is allowed for multiple member payments if all member forms are with the payment.
9. SUBMITT FORM:
Renewals ONLY- mail via USPS the form and payment (if applicable) to P.O. Box 534, Quarryville, PA 17566.
You can also submit your renewal and payment at a monthly membership meeting.
New Members-at orientation ONLY, in person, with picture ID. DO NOT MAIL.
10. CLARIFICATIONS:
*Your gate card will be suspended if you do not renew in time and you may lose your “current” member status.
You may have to rejoin as a “New Member”. Range and members only website access will be suspended while
being resolved.
*NO PAYMENTS WILL BE DEPOSITED BEFORE NOVEMBER. This is for club fiscal year accounting. Allow at least 6
weeks for processing. Do not stop payment.
* Newsletters are sent to every member who requests one. Six (6) issues bi-monthly. Immediately inform us of email o
r
p
hysical address changes or if you are not receiving your newsletter. Please send updates to contact@slcfsa.org.
To receive your first newsletter of the year, Jan/Feb, your renewal must be received and accepted as complete
and in process by the first Friday in December. Otherwise, you will begin receiving newsletters beginnin
g
Mar/Apr. New Members will begin receiving the newsletter the first issue after their orientation.
Rev. 8-15-2021
FORM MUST HAVE SIGNATURE ON WAIVER TO BE ACCEPTED AS COMPLETE
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SLCFSA MEMBERSHIP FORM Payable to SLCFSA

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Completed 7 October 2021

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