Sno membership form 2012

Membership Application Form October 1st, 2011 thru September 30th, 2012 YES, I WISH JOIN THE SNO*BLASTERS CLUB… Last Name_________________________ First Name_________________________ Name of Spouse, or Significant Other_____________________________________ Address________________________ City____________________ State________ Zip________ Home Phone_______________________ Cell____________________ Email_______________________________________ Number in Family_____________ Children’s Names Under the age of 18__________________________ __________________________ __________________________ __________________________ Sno*Blasters is an A.W.S.C. Club. Are you already a member of A.W.S.C. through another Club? If so, what club? _________________________________ Type of Membership Θ New or Θ Renewal Θ Family/Single Membership $25.00 Θ Business Membership $50.00 (If you belong to another club that has paid your AWSC dues, you may deduct $10.00 for Family/Single and $27.00 for Business membership) Submit check payable to “Shawano Lake Sno*Blasters” and mail to: Kateri Brei Questions call: N6397 Lake Drive Clarence Schampers @ 715-526-2465 Shawano, WI 54166 Kateri Brei @ 715-851-3929 Dues include our membership, A.W.S.C. membership, WI Snowmobiler Magazine, A.W.S.C. insurance benefit of $2,500 death benefit, $2,500 wife or child, legislative voice, and all club mailings. WELCOME! WE LOOK FORWARD TO SEEING YOU AT OUR CLUB MEETINGS AND ACTIVITIES!