CARLISLE FISH & GAME ASSOCIATION, INC
 P. O. BOX 157
 CARLISLE, PA  17015-0157
                              DATE: ___________________
 NAME: __________________________________________________________________
ADDRESS: _______________________________________________________________
CITY:  _______________________ STATE:  __________ ZIP CODE: ______-_____
PHONE:  ___________________________________________________________
 
SINGLE MEMBERSHIP FEE SCHEDULE (AS OF 1 OCTOBER 2007)
SENIOR (AGE 65 THRU 79)     ___ NEW $45  ___ RENEW $30
SENIOR (AGE 80 AND OLDER)                ___ RENEW $10 (MUST HAVE BEEN A MEMBER IN THE PREVIOUS YEAR)
ADULT (AGES 18 THRU 64)     ___ NEW $65  ___ RENEW $50
JUNIOR (AGES 12 THRU 17)    ___ NEW $25  ___ RENEW $20  BIRTHDATE____/____/____
SUB-JUNIOR (AGES 6 THRU 11)      Available only with family plan

LIFE MEMBERSHIP _____ $400
(Must be approved by Board of Directors and must be a member in good standing for at least one year)

 SPONSOR (PLEASE PRINT CLEARLY)  _____________________________________                             

  FAMILY MEMBERSHIP:
 SPOUSE:    ____________________________________________
 CHILDREN:  ____________________________________________ BIRTHDATE____/____/____
 (under 18) ____________________________________________ BIRTHDATE____/____/____
            ____________________________________________ BIRTHDATE____/____/____
            ____________________________________________ BIRTHDATE____/____/____   (Use back of form if necessary)
  FAMILY MEMBERSHIP FEE SCHEDULE:
    HUSBAND & WIFE ONLY ...............SENIOR: ___ NEW  $90  ___ RENEW $55
                                       ADULT:  ___ NEW $130  ___ RENEW $95
    TWO ADULTS & CHILDREN UNDER 18.....ADULT:  ___ NEW $135  ___ RENEW $100
    TWO SENIORS & CHILDREN UNDER 18....SENIOR: ___ NEW  $95  ___ RENEW $60
    ONE ADULT & CHILDREN UNDER 18......ADULT:  ___ NEW  $75  ___ RENEW $55
    ONE SENIOR & CHILDREN UNDER 18.....SENIOR: ___ NEW  $55  ___ RENEW $35
Membership is open to anyone 6 years of age or older.  All club activities are open to all members.  Members who lose fish or game license privileges will be dismissed.

Make checks payable to:  CARLISLE FISH & GAME

Send applications to:   Membership
                          Carlisle Fish & Game
                          PO Box 157
                          Carlisle, PA  17015