|--- OFFICE USE ONLY ---
Last Name: | Membership #
| Date returned:
Address: | <> cash <> check #
| amount:
City: | Board review date:
| Computer entry date:
State, Zip+4: -----------------------
Home telephone:
E-mail address:
- - M E M B E R - - - - S P O U S E - -
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First Name | | |
Occupation | | |
Work shift | | |
Work telephone | | |
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Number of
Snowmobiles
Names and Ages
of your children
under 18
A directory of members names and telephone
numbers will be distributed to the membership.
DO YOU WISH TO BE INCLUDED (Y/N) -->
The following information has been requested for use with
our emergency assistance in snow emergencies, etc...
-- do you own a CB radio (Y/N) -->
-- a 4-wheel drive vehicle (Y/N) -->
-- Should we call you for help (Y/N) -->
List any ideas you have for events: