Jefferson Hilanders Snowmobile Club Membership Form

Jefferson Hilanders Snowmobile Club

P.O. Box 273

Jefferson, NH 03583

Membership Form

Name : _______________________________________

Street Address : _______________________________________

City/Town: ___________________________ State_______ Zip _______

Email: _________________________________________

Phone Number: ______________

Family Membership 2nd card name: ______________________________________

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$10.00 of your membership dues entitle you to a membership in NHSA and a one year subscription to SNO-Traveler

magazine. (NHSA membership is mandatory in NH)

Are you a current NHSA Member? Yes____ No ____(if you have joined another club you already belong)

If yes, Indicate your NHSA Card Number: ______ and the club who issued it ___________________________

and deduct $10.00 from the single or family membership fee.

One year membership (Membership runs from July 1st to June 30th)

_______Single Membership $25.00

_______Family Membership $30.00

_______ Donation $ _________

TOTAL DUE $ _________

Thank you for your support & please mail to: Jefferson Hilanders SC PO Box273 Jefferson NH 03583.