MEMBERSHIP APPLICATION

Instructions: Print form, fill out and mail to address below. Include check made out to: Utah Snowmobile Association.

Date: ___________________              New Member     Renewal    Business    Other

Family or Individual:

Last Name: ________________________________    First Name: ___________________________________ 

Spouse:  ___________________________________  

Address: ____________________________________ City: _______________________  State: ____ 

Zip:  ______________   Phone: ____________________________  Cell Phone: _______________________

Email: _______________________________________________________

Local Club____________________________________________________

*** Additional Family Members ***

Name: __________________          Name: ____________________     Name: ________________________           

Name: __________________          Name: ____________________     Name: ________________________

Business:

Company Name: _________________________________________ Contact: ______________________

Address: ___________________________________ City: __________________  State: ____

Zip: _______________  Phone: _________________________  Cell Phone: ________________________

Email: ______________________________________________________________

Web Address: _______________________________________________________

Memberships:

   Individual $20    Family $30    Student (age 17 – 23) $25   Business $75    Other _____________________

                                                                                                                Total Contribution:  _________________

Mail Applications:

Utah Snowmobile Association
P.O. Box 901118
Sandy, UT 84090-1118