MSSA Membership and
Affiliation Application

 MSSA is not equipped to accept applications or payments online.  Please print out this form, complete it,  and mail it with payment (checks only please) to:

Missouri Sport Shooting Association

PO Box 10170

Columbia, MO 65205

MSSA reserves the right to refuse any business we feel is contrary to the interests, purposes and objectives of our Association and its members.  For information about your MSSA Membership or Affiliation status, please contact MSSA Secretary Harold Miederhoff.  For advertising rates or other information about The Missouri Shooter, contact Managing Editor Sheila Stokes-Begley; for information on listing your business on the MSSA Business Partners webpage, contact MSSA Webmaster, Zac Bauer.


Name: ___________________________________________


City: ____________________________________    State: __________________ 
Zip: ____________

Email: _________________________________ 
Website: ___________________________________

Sponsor (optional): __________________________________________________________________

Regular Annual Membership/Affiliation


Donor Annual Memberships

q Adult Membership $15.00


q Sustaining Membership $50 - $99

q Junior (under 18) Membership $5.00


q Silver Sustaining Membership  $100 - $499

q Annual Club/Organization Affiliation $25.00


q Golden Sustaining Membership $500+

Life Memberships



q Regular Life Membership $250.00



q Benefactor Life Membership $500.00



Donations to MSSA and its programs



$_________ Donation for MSSA Junior Program


$_________ Donation for any use by MSSA

$_________ Donation for a specific purpose: _______________________________________________