VIRGINIA Gun Owners Coalition 
Internet Application Form

PRINT OUT THIS FORM AND MAIL
IT TODAY!

To:     Mike McHugh, President
	Virginia Gun Owners Coalition
	PO Box 1599
	Front Royal, Virginia 22630

Print Full Name:     

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Print Street Address, Town, Zip 

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 YES!  I want to join Virginia Gun Owners Coalition.
  I want to help you fight to preserve and restore my 
  constitutional right to keep and bear arms for myself
  and future generations.

Choose your level of membership for November 2005 - November 2006:

 I will join at the suggested donation amount of $100.
  I realize that the success of our legislative AND election season
  efforts depend upon the generosity of regular members.

 I cannot afford $100 but I want to do all I can to help VGOC grow bigger,
  and stronger.  I realize that mobilizing more gun owners depends on the
  generosity of everyone doing what they can.  I will donate:

							     $____________

 Please add my e-mail to the Defend Liberty e-mail alert system.  My 
  current e-mail address is:

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 I realize that in the fast and intense information age, winning and losing
  often depends on speed of communications.  I don’t want gun owners to
  be out flanked by the gun grabbers.  My phone number is:


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		          Thank you for joining VGOC !