Belknap Snowmobiler's Inc.
Membership:  New   Renewal

Membership $25.00 (Inculdes NHSA Membership)
Donation to Groomer Fund  -- Fill in the amount: $
Decals - Extra Decals - $1.00 each - - How many decals:
List Both Spouse's name if applicable:
First Name: 
Last Name: 
 
 
First Name: 
Last Name: 
 

Address:
Please use deliverable address - NOT summer address
             
City: State:   Zip:       
Telephone: 


E-mail Address :      # of Snowmobilers in family:  

Please Check one of the following:
Yes, I want to receive the monthly newsletter via regular mail
No, Send no newsletter at all
Yes, I would prefer to receive the monthly newsletter via E-Mail
Are you a member of NHSA through another club?
                      Please provide Club Name and NHSA #

Payment Information:  Check Number
 
Please complete this form and print, then mail or fax to:
Belknap Snowmobiler's Inc., PO Box 7224, Gilford NH 03247-7224 - fax to: 603.528.0494
Questions
603.528-3310 - fax 603.524.0494 or Email