TEAM ID CODE

Please fill in Coach’s Last Name: _____________________________________

State Abbreviation

SCTP NSSA-NSCA MEMBERSHIP APPLICATION

Scholastic Clay Target Program- http://sssfonline.com/about-sctp
PLEASE NOTE: THIS PROGRAM IS AVAILABLE TO YOUTH ONLY

Please check the applicable box or boxes.

(Please list membership # along with contact info if you are a current member)

MEMBER INFORMATION: SCTP MUST BE UNDER THE AGE OF 21

NSSA Regular SCTP Membership (Monthly Digital Magazine): $10

NSSA Regular SCTP Membership (Monthly Digital and Printed Magazine): $32

NSCA Regular SCTP Membership (Monthly Digital Magazine): $10

NSCA Regular SCTP Membership (Monthly Digital and Printed Magazine): $32

Male Female

Membership#(NSSA): Membership#(NSCA):

Name: Birth date:

First Middle Last Month/Day/Year

Address:
Street or Box

City State Zip

Phone: E-Mail:

PAYMENT INFORMATION:

Check enclosed Credit Card number:

MasterCard VISA AMEX Discover

Expiration Date (mm/yy): / Security Code#______

Signature:

Please include a check or credit card information for membership.

NSSA-NSCA
Re: SCTP Registration
5931 Roft Road
San Antonio, TX 78253