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 Mitch Peters; for information on listing your business on the MSSA Business Partners webpage, contact MSSA Webmaster, Melissa Mata.


Name: ___________________________________________

Address: __________________________________________________________________________

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: _______________________________________________


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