MEMBERSHIP APPLICATION

Mailing Information:

Name: _______________________ Date: ________

Address: _______________________ NHSA #________

City/Town: ______________ State: _____ Zip: _______

Home Telephone#(___)___________

Local Information:

Address:

Telephone#: ___________________

* Single Membership: $20.00 $___________

*Family Membership: $25.00 $___________

All memberships include membership in the New Hampshire Snowmobile Association. New Members will also get a patch and all members will receive the Sno Traveler a monthly newspaper put out buy the NHSA.

*Groomer Donation $___________

*Easter Seals Donation $___________

Total paid $___________

Send to: ALC, 80Patten Rd, Alexandria, N.H. 03222