Name: _______________________________________

Address: ____________________________________

Town: _______________________________________

State: __________ Zip Code: _________________

Date of Birth: ____/____/____ Age: ___________

E-Mail: ______________________________________

Please Fill Out The Requested Information and Mail This Form To:  27th NJVI  55 Main St. Apt3 Hackettstown NJ

                               07840

All Military Members Must Be 16 Years Or Older To Handle Weapons.  Any Member Under The Age Of 16 Must Have A Parent Or Guardian Present At All Events.

DUES:  Are Currently (2023) $30.00 Per Member To Cover Unit Insurance And Website Maintanance. PLEASE MAKE ALL CHECKS PAYABLE TO "PAM COVERT"