Southern Cross Hunt Club Membership Form

Mail or E-Mail(as an Attachment): “Southern Cross Hunt Club”  c/o Robin Clark 4806 San Juan Avenue Jacksonville, Florida 32210    

Name: ______________________________________ Age:___________    

Address:____________________________________________City:_______________   State:__________________  Zip Code__________   

Phone:(H)_______________________ (C)__________________________    

E-Mail Address:_______________________________________    

Type Of Employment:____________________________________________     

Spouse:__________________________________________    Age:___________    

Number of Children: _______ Ages: ________________________________   

 Please Tell Us about Yourself, Your Experience and What Your Looking For:  

You’re Hunting Experience Level? Old Hat_____ Moderate_____ Newbie_____ 

How Many Years Have You Been Hunting?________ 

How Many Hunting Clubs Have You Been In?_______ 

Have You Ever Been Charged With Any State Game Violation? __________

Is "QDM" Something That You Believe In? __________  

Do You Enjoy Work Days & Participation in Club Needs? _________   

Please Tell Us about Yourself:   


 I have read the "Southern Cross Hunt Club” Basic Regulations and the "QDM" measures.    

Signature: _________________________________________ Date: ___________