(Fill out for one individual
per form)
Name: ( _______________________________________ )
Addr: ( _________________________________________ )
City: ( ______________________ ) State: ( ___ ) Zip ( ________ )
Phone: ( _____
- _____ - ___________ ) Date of Birth (___-____-____)
Email Address:
(_____________________)
Circle (one)
pitching category that is applicable:
(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
(For new members):
Have you held NHPA membership before and if so,
how many years and
in which State(s):________________________
Send this
(completed) form to Charter Secretary:
William Choser,
356 Wakelee Ave, Ansonia, CT 06401-1226
with check or
money order (US Currency) for $20.42*** for adults (age 18+)
Or $5.42 for
juniors (ages thru 18)
(Note $0.42 is for
postage). You will receive a combination
NHPA/Charter
MEMBERSHIP CARD with your card number.
Your card will
allow NHPA sanctioned tournament entry 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.
Check here for Newsline
____
***Revised November, 2008 (postage increase)***
Annual Memberships are
issued thru December 31st
More details available on
NHPA website www.horseshoepitching.com
Central Connecticut HS Club
website www.ccthc.com
CT HPA OFFICERS:
Jim
Halligan-president, Susan Henson-vice pres., Don Maine-treasurer