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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Are you a current NHSA Member? Yes____ No ______
If so, Indicate your NHSA Card Number: ___________________
If you have joined another club, indicate the card number & deduct $10 from total: ____________
_______Single Membership $25.00
_______Family Membership $30.00
_______ Donation $ _________
TOTAL DUE $ _________
Thank you for your support & please mail with a S.A.S.E to the address listed above.