PETOSKEY SNOWMOBILE CLUB

MEMBERSHIP APPLICATION

NAME __________________________________________________________

ADDRESS __________________________________________________________

CITY _________________________ STATE________ ZIP ____________

PHONE ____________________ CELL PHONE _____________________

EMAIL ADDRESS _________________________________________________

MEMBERSHIP TYPE ___ SINGLE ($15 / YR)

___ FAMILY ($30 / YR)

FAMILY MEMBER NAMES

__________________________

__________________________

__________________________

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SIGNATURE ___________________________________________________________

PLEASE FILL OUT THE ABOVE FORM AND MAIL ALONG WITH YOUR DUES PAYMENT TO:

PETOSKEY SNOWMOBILE CLUB

P.O. BOX 853

PETOSKEY, MI 49770

For Club Use Only

APPLICATION RECEIVED ON _______________

PAYMENT RECEIVED __________

APPLICATION ACCEPTED? (Y/N) ________

IF NO, STATE REASON ________________________________________

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CLUB SIGNATURE _______________________________ DATE __________________