Membership Form
Print and return to:
Pheasants Forever C/O Cory Brix
24845 Chicago Ave; Deerwood MN 56444
218-851-9775
| Banquet Ticket - Includes PF Memberhship, dinner and door prize chance. Must purchase to attend banquet. | $55.00 | X | $ |
| Spouse Ticket - Includes dinner and door prize chance. | $35.00 | X | $ |
| Ringneck Ticket - Includes Membership (15 & under), dinner, door prize chance & special drawing. | $30.00 | X | $ |
| Sponsor Ticket - Includes PF Membership, 2 dinner tickets, sponsor print & drawing for a special sponsor only gun drawing (one gun every 10 sponsors). | $250.00 | X | $ |
| Cannot Attend - but please process/renew my membership. | $30.00 | X | $ |
| Raffle Ticket Package - Rooster Booster ticket package worth $150.00 | $100.00 | X | $ |
|
Total |
$ |
Name _____________________________________________________________________ **Remember to return your registration and payment, postmarked no later than February 1, 2010 to be eligible for the pre-banquet drawing for a $150.00 ticket package.**
Payment Information: Check amount $___________________
Or Credit Card Information - Visa or MC (please circle).
Number _________________________________________ Exp.date ___________________
Spouse Name __________________________________________________________________
Ringneck names(s) and age(s) ____________________________________________________
Address _____________________________________City, State & Zip ___________________
Phone # ______________________________________________________________________
Make checks payable to Aitkin County Pheasants Forever
If you would like more information or wish to make a cash or merchandise donation, please contact
Cory Brix at (218) 851-9775