The Deering Fish & Game Club, Inc.

P.O. Box 694

Hillsborough, NH 03244

dfandgame@yahoo.com

Club Membership Application

(Please Print Clearly)

Name:_________________________________ Address: Line 1:____________________________

Line 2:_________________________________City/Town:________________________________

State:__________________________________Zip Code:_________________________________

Home Phone#:___________________________ E-Mail:__________________________________

Mobile Phone# (Optional):______________________________________

Membership Options, Please Check (One):

(__) Single-One Year Membership, $70.00

(__) End Of Current Year Plus Membership, Last Four Months Plus Next Year, $94.00

(__) Family-One Year Membership, Two Parents and Children (Up to age 18). Children must be

accompanied by at least one parent, $110.00

(__) Military Membership: Free, When Using The Range Just Present Your Active Military Service

Card

Please, make your checks payable to:

The Deering Fish & Game Club, Inc.

Applicants Signature:

[x]_______________________________________

Date:_____________________________________