Now it's Easy to Renew Online
2012 Membership Renewal Form
This is the fastest and easiest way to renew your membership.
You can use your Paypal Account or your Credit or Debit Card.
Your credit card information is sent directly to the credit card processor in a highly secure manner.
We protect you by ensuring that nobody but you and the automated credit card processor
will see your credit card information.
Type of Membership
Choose One Please
New
Renewal
Date
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
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25
26
27
28
29
30
31
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
First Name
*
Last Name
*
Mailing Address
*
City
*
State
*
Zip Code
*
Email Address
*
Confirm Email Address
*
Day Time Phone
*
Night Time Phone
Spouse Card
Choose One Please
Yes
No
Spouse membership cards are available upon request. A new member orientation may be required. We will gladly issue a spouse card if the spouse will be using the club facilities by themselves. If the spouse will always attend the club with the voting member an individual card is not required.
Name of Spouse
Choose
ONE
Membership Level
Our on-line membership renewals have been raised $2.00 per membership to include a processing fee.
Thank you for understanding.
RENEWAL MEMBERSHIPS
$52.00
Renewal General Membership
$42.00
Renewal Senior Membership
NEW MEMBERSHIPS
$52.00
New General Membership
$42.00
New Senior Membership
Would you like to donate to our building fund?
Just choose the amount below and it will be included with your Paypal or Credit Card Account. We thank you in advance for your donation to the Siuslaw Rod & Gun Club.
Donations are NOT tax deductible as we are a 501 C7 Corporation.
$10.00
Building Fund Donation
$15.00
Building Fund Donation
$25.00
Building Fund Donation
$50.00
Building Fund Donation
$100.00
Building Fund Donation
$250.00
Building Fund Donation
Total:
Special Comments
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Please read before proceeding:
You do not need a PayPal Account to renew your dues but if you do have one it makes the one step process easy.
Just choose your membership renewal level or type on the right side and if you want to contribute to our building fund (this is optional).
When you get to the PayPal screen you will see a notice that if you DO NOT have a PayPal account you may use your credit card, just click on that link to enter your credit card information. PayPal is owned and operated by eBay Inc. and is a Secure Check Out.
This is a 2 step process, 1) this form will forward your information to the clubs data base. 2) After you submit you will be taken to the check out page of PayPal there you will enter your credit card or PayPal information securely.
Please ONLY Choose "Submit" if you plan on continuing with your renewal.
Type of Membership
Date
*
First Name
*
Last Name
*
Mailing Address
*
City
*
State
*
Zip Code
*
Email Address
*
Confirm Email Address
*
Day Time Phone
*
Night Time Phone
Spouse Card
Name of Spouse
Choose ONE Membership Level
Special Comments