Affiliation Application Form (Page 4 of 4) in pdf

Affiliation Application Form Page 4

CMP Affiliation Application Form

Page 4 Updated 09/23/2014

Check List. Please use this check list to be sure

you have completed or included everything required

____ Affiliation Application Form (this form)

to approve your application.

____ Club documents included (constitution, by-laws,

other government documents)

____ Affiliation fee included ($30.00)

*Note: If you are considered an MOU Affiliate (a JROTC, Boy

Scouts Crew/Venturing Crew or a 4H Shooting Sports Club),

please do not send payment.

Please include $30.00 payment with this Report

After your organization’s Affiliation Form is processed, the

(unless your organization is considered an MOU

CMP will forward your organization’s CMP Affiliation

Affiliate). Make checks or money orders payable to

Certificate. Assistance in completing this form or additional

the “Civilian Marksmanship Program” (CMP).

information is available by contacting the CMP Affiliate

Please mail your completed Affiliation Form with

Relations Coordinator, tel. (419) 635-2141, extension 1182, or

payment to:

CMP Affiliate Relations

P.O. Box 576

Port Clinton, Ohio 43452

Credit Card Information. Provide credit card information below. MasterCard, Visa, Discover and American

Express credit cards are accepted. If you are paying by credit card, you may fax your completed Application Form to

(419) 635-2802.

Credit Card (circle one)

MasterCard

Visa

Discover

American Express

Card No:_______________________________________ Exp. Date:__________________ CVV2#:__________

Name on card:__________________________________ Signature:___________________________________

Affiliation Application Form Page 4