Yes! I would live to be a part of the CLHA!

Name: _______________________________ Age: ___________
Address: _____________________________________________
City: _______________________ State: ______ Zip: _________
Telephone Number: (Home) _____________________________
Telephone Number (Work) ______________________________
E-mail Address: ________________________________________
Do you own a flintlock firearm? YES_____NO____
If you are a New Jersey resident,
do you have a NJ Firearms ID Card? YES_____NO____
Please List all family members who would be participating:

			

				

					
Name
					
Age
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
				

					
______________________________
					
_________
				
			
		
Date: _________ Signature: ______________________________

When completed, please mail to:

Bill Cooper
CLHA
PO Box 531
Blairstown, NJ 07825