| West End Trail Blazers, Inc. Snowmobile Club PO Box 69 Roulette Pa. 16746 Application for Membership Sept.__________ to Sept.___________ Name_________________________________________ Address__________________________________________ Phone#: Home - (____) ______________ Cell - (____)____________ email: ___________________________________________________ Circle one: Single: $10.00 Family -- $15.00 (# in family_____) Business -- $25.00 Please print, complete and send with a check or money order to address listed at the top |
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