SEELEY LAKE DRIFTRIDERS

2011-2012

MEMBERSHIP APPLICATION

ANNUAL DUES:  (Nov 2011-Oct 2012)

• o     New             £ Renewal
• o     Business————–$40.00 (Includes Advertising on our website)
• o     Family—————–$35.00
• o     Individual————-$25.00 
• o     65  & up $5 discount
• o     Grooming Donation_____ 

Number of Actual Riders_____

£ Newsletter Ads $10/issue or $50/year

NAME:___________________________________________________

ADDRESS:________________________________________________

CITY, STATE, ZIP:_________________________________________

PHONE #:________________________________________________

EMAIL:__________________________________________________

If you would like to receive newsletter via email please check box: ( )

Please mail to:

Driftriders

PO Box 174

Seeley Lake, MT 59868

THANK YOU FOR YOUR SUPPORT!

Look for your monthly newsletter.

And visit our website @ www.driftriders.org