CLUB APPLICATION
 
MISSING LINK SNOWMOBILE CLUB
P.O. Box 844
Carthage, NY  13619
____________________________________________________________________________________
print out this page - then write the information in  /  Mail to above address with $30.00
 
First Name (PRINT ONLY): __________________________________________________
Last Name: __________________________________________________
Street Address/PO Box: __________________________________________________
City: __________________________________________________
State:  __________________

Zip Code:

________________________
 
Family Membership Information

Spouse:

First Name

___________________

Last Name

_____________________
Children under 18 that intend to register a sled:
_____________________________________________________________________________________
 
Phone #:  __________________________________
Email address:  ____________________@______________________________________
(DMV Voucher, NYSSA News letter and other information can be emailed)
 
(     ) Club Membership $30.00
(     ) NYSSA Trail Defender membership upgrade additional $20.00
 
 
Have you already paid NYSSA Dues this season via another club?      (circle one) YES NO
If so, which Club:  _______________________________________________    
 
Twenty five cents of your $5 NYSSA dues will be used for the NYS Snowmobile PAC (Political Action Committe) who is our voice in Albany.  If you do not wish to contribute to the NYS Snowmobile PAC, please check this box.  [    ]

Please note, your NYSSA dues remain $5.00

 
 

__________________________________________________________________________________________________

For Club use only

Blank Voucher ID issues (ex 07-140-B183): ___________________________
Snowmobile Trail Landowner [   ]
EMBED 3/4

 

Copyright 2001 Missing Link Snowmobile Club
Last modified: January 19, 2012