Blue Mountain Snowdusters ORC, Inc.

Membership Application / Membership Renewal Form

Membership must be current in order to participate in the annual club elections.

Name:_________________________________________________

Phone: (_____) _________-_____________

Address: _______________________________________________

City:_________________________________ State:_____________

Zip Code:____________________

Email:_________________________________________________

Membership Desired (Choose one):

Family Plan…….$30             Individual (16 years and over)…….$20

Do you wish to receive the NHSA SnoTraveler?    Yes     No

Main Interests (circle all that apply):     Hiking     Snowmobiling     Fundraising Events

Horseback Riding   X-Country Skiing   Mountain Biking   Other______________