Entryform 12th Annual

Springfield Armory Single Stack Classic /USPSA National Championship

Dates:	April 27th - April 28th (April 29th is for weather make-up if needed.)
Location:	P.A.S.A. Park, - Barry, IL
Capacity:	250 Competitors (125 Each Day)
Stages:	14-16 Challenging Courses
Entry Fee:	$135.00 for Current 1911 Society Members
	$150.00 for Non-Members
	$190.00 Non-USPSA Member (Includes 1st year membership.)
	(Entryfee includes lunch.)
	Entries Accepted on a first come, first serve basis!
Entry Deadline:	April 10th, 2007
	*Full Refund for withdrawal if written & signed request received before April 10th,2007. No refund after that - No exceptions!*
Rules:	USPSA Provisional Single Stack Rules Apply.

Make checks Payable to:
1911 Society/SSC
Complete entry form and
mail with check to:

1911 Society
c/o Heinie Specialty Products Inc.
301 Oak Street
Quincy, IL 62301

Sunday, Weather Make- up if needed. For special squadding request, please send entries together.

MATCH SPONSOR:

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Name____________________________________

Address__________________________________

City_____________________ State____________

Zip______________Phone___________________

Email Address ____________________________

1911 Society Membership# ___________________

USPSA Membership # _______________________

Ammunition Power Factor (Circle)

Major Minor

Prefered Shooting Day (Circle)
Friday ---------- Saturday

Enter Early to get preferred shooting day. If you want to shoot in the same squad, send all entries together.

For more Information call 1-217-228-9500