Greene County Regulators Membership Application

Date_____________

Name______________________________________

Alias______________________________________

SASS #__________

Address_____________________________________________

____________________________________________________

Phone #______________________

Email Address________________________________________

Membership dues are payable on January 1st of each year.
Individual membership is $30.00 per year.
Family membership is $50.00 per year.
Members that join after the June monthly match are prorated at
$15.00 for individual membership and $25.00 for family membership.

Type of membership (circle one) Family - Individual
Amount paid___________

Make checks payable to: Greene County Regulators
Simply bring this to a match or mail to:
Greene County Regulators
231 Norfolk Circle
Harrogate, TN 37752

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