Trail Hounds Snowmobile Club

351 County Route 12

Pitcher, New York 13136

607-863-3968

Leebement@yahoo.com

MEMBERSHIP APPLICATION

NAME____________________________________________________________________

SPOUSE NAME_____________________________________________________________

NUMBER  of CHILDREN ________NUMBER of REGISTERED SNOWMOBILES_________

CHILDREN UNDER 18__________________________________________________________

                                  List only children 17 and under who intend to register a sled in their name

ADDRESS (must match address on registration)

_____________________________________________________________________________

CITY _______________________________STATE ___________ ZIP______________________

PHONE_______________________________________________________________________

EMAIL_______________________________________________________________________

ARE YOU A MEMBER OF NYSSA THRU ANOTHER CLUB YES ____NO____

IF YES DID THEY ISSUE YOU A VOUCHER YES ____ NO___

PLEASE ENCLOSE CHECK OR MONEY ORDER FOR $25 LANDOWNERS FREE

______________________________________________________________________________

CLUB USE ONLY

CHECK __________VOUCHER _____________ CARD ____ QB ___ AD ___ NYSSA ___ SENT ___

COUNTY_______________________________________

This is the only form Lee will except!!!!

To print this out just Highlight the text and paste it in WordPad/notepad/word and print!!!