M
anitoba
P
rovincial
H
andgun
A
ssociation
MPHA - Individual Membership Application:
Your Full Name:
*
Age:
Street Address:
*
City:
*
Province/State:
*
Postal/Zip Code:
*
Telephone:
(i.e.: 204-123-4567)
Email Address:
*
Club Affiliation:
*
Membership Fee:
$10.00 - Individual
$25.00 - Club
(includes G.S.T.)
- I would like
crest(s) at $4.25 each.
(includes G.S.T.)
- I would like
pin(s) at $3.25 each.
(includes G.S.T.)
*
REQUIRED ENTRY
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