NHPA MEMBERSHIP APPLICATION

CONNETCIUT 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: _______________________________________________________

MEMBER’S NHPA CARD NUMBER: _____________________________________________

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

Circle (one) pitching category that is applicable to 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 $20.49 for adults (age 18+) or $5.42 for juniors (ages thru 18) $0.429is for postage. Annual memberships are issued thru December 31^st

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

CT HPA OFFICERS: Paul Jary-president, Posistion Vacant-vice pres., Bob Carl-treasurer,

Debbie Scully - charter secretary

CONNETCIUT HORSESHOE PICTHERS ASSOCATION

WEBSITE: www.cthorseshoepitching.com