Membership Registration Form

Please print and fill out the infomation below.
Please Make Checks Payable To:
New Hampshire Snowmobile Museum Association, Inc.

And send the form and the check to
NHSMA
PO Box 10112
Concord, NH 03301-0012

for more information:
stephenburdick@nhsnowmobilemuseum.com
603-648-2304

NHSMA Member Registration

Name:___________________________________________________________________

Street Address:_________________________________________________________

City, State & Zip:______________________________________________________

Email Address:__________________________________________________________

Phone:__________________________________________________________________

Individual    $20 ____                      Sustaining          $75 ____

Family        $25 ____                      Business           $100 ____

Club          $50 ____                      Life Member        $500 ____

**Memberships come due yearly in December.

ADDITIONAL DONATIONS:

Events:       $_______                      Maintenance:       $________

Website:      $_______                     Restorations:       $________

Please check here if paid online with Pay Pal:_____
(Please attach Pay Pal receipt to application)