ANNUAL NHPA MEMBERSHIP APPLICATION
CONNECTICUT HORSESHOE PICTHERS ASSOCATION
Each player must complete application annually / application must be legible

NAME:

ADDRESS:

City:†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† STATE: __________ ZIP CODE :

PHONE :††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† DATE OF BIRTH:

E-MAIL ADDRESS:

MEMBERíS NHPA CARD NUMBER:

(IF NEW MEMBER ... WRITE NEW MEMBER ON THE LINE ABOVE)

Circle (one) pitching category that is applicable for you:

(M)en (full dist.) (W)omen (short dist.) (E)lders (short dist, age 70+)
(B)oys (short dist.)††† (G)irls (short dist.) (H)andicap (short dist)
Note: (H) pitchers must be certified by CT HPA

Send completed form to Charter Secretary:

Debbie Scully - 58 Maplewood Ave. East Hartford, CT. 06108

Include check or money order for $20.42 for adults (age 18+) or $5.42 for juniors (ages thru 18) $0.42 is for postage. Annual memberships are issued thru December 31st

Your card number is a combination NHPA/Charter membership card. This card will allow NHPA sanctioned tournament entry in any National, Regional, State, local tournaments and sanction leagues, anywhere in the USA (in accordance with NHPA Bylaws and Rules).

If you wish to subscribe to the NHPA Newsline magazine, you may enclose an additional $12.00 for a 12 month subscription.

CT HPA OFFICERS: Paul Jary-president, Susan Henson-vice pres., Don Maine-treasurer,
Debbie Scully - charter secretary

CONNECTICUT HORSESHOE PICTHERS ASSOCATION
WEBSITE: www.cthpa.com