2001-2002 membership application

Name______________________________                      phone____________

Street______________________________                       Zip______________

City/Town____________________    State__________________

*  E MAIL*  ( Very important if you have one)_____________________ 

___________________________________

Names of dependent children 17 years of age and younger:

_______________________                    ________________________

_______________________                   _________________________

check one:               New member____        renewal____

family membership____  $25.00 enclosed    

single membership____    $15.00 enclosed

members signature__________________________    Date__________

mail to::  Vanderbilt snowmobile club  p.o. box 332 Constantia n.y. 13044

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verification by club representative________________ Date___________          GO BACK