BMC Membership/Renewal Form

Membership/Renewal Form

Name

Address

City

State

	Zip

Phone

(please provide email address so we can notify you about upcoming club events)

Select One:

	Yes, I authorize my name, address, phone, and email address to be distributed to any club member
	No, I do not authorize my name, address, phone and email address to be distributed to anyone

Select One:		Individual Membership - $10.00
		Family Membership - $15.00

We are a 100% PSSA member club.

Membership runs from January 1 to December 31.

Membership will be maintained the following year until March 1st, at which time, non payment of dues will result in the membership lapsing for the year. Reinstatement can be made by paying the full amount of the dues owed for the year.

Dues taken from the beginning of Agust will be for the next year's dues.

Please send completed application with payment to:
Black Mo Snowmobile Club
157 Valley View Road
Bellefonte, PA 16823
http://www.blackmosnow.com