APPLICATION for
MEMBERSHIP ON THE 2006 NTA ALL-STATE TEAM

Based on 2005 scores

Name:

Address:

Date of Birth:

ATA #:

NTA #:

Category: (circle one) Age is determined on the 1st day of the Trapshooting Year or 09/01/04.

Top 10     Lady      Veteran (65 to 70)     Senior Veteran (70 +)     Junior (15 to 17)     Sub-Junior (14 & under)

Number of Targets Shot in 2005 (9/1/04 through 8/31/05)

  Singles:_______     Average:_______       Handicap:_______   Average:_______

  Doubles:_______   Average:_______       Average over-all:_________

Signature:_____________________________________________________

Targets Required:
  Category   16 Yd.   Handicap   Doubles
  Top Team (10 Shooters)   2,500   1,500   1,000
  Lady   2,000   1,500   750
  Veterans   2,000   1,500   750
  Senior Veterans   2,000   1,500   750
  Junior   1,000   1,000   500
  Sub-Junior   1,000   1,000   500

Mail completed form to NTA Secretary/Treasure by 12/31/05:
Marilyn J. Behrens, 740 East 2nd Street, Crete, NE 68333