ANDROSCOGGIN VALLEY ATV CLUB
MEMBERSHIP APPLICATION
Membership’s expire on June 30.
Date:
________________
Name:
__________________________________________________________________
Address:
________________________________________________________________
City/Town:
_______________________________ State: _________ Zip: ____________
Phone Number:
__________________________________________________________
E-Mail:
_________________________________________________________________
Single Membership
$20.00: ____________ Family Membership $25.00: _____________
Donations: _____________ How many ATV’s:_________
Are you interested in helping with the club functions? Yes _____ NO _____
Please make check
or money order payable to: Androscoggin Valley ATV Club
Mail Application
and Check to:
Androscoggin
Valley ATV Club
PO Box 534
Berlin, NH
03570
