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Mid Jersey Ski Club Application Form

P.O BOX 5705

CLARK N.J 07066

2005 / 2006 DUES & ROSTER INFORMATION

PLEASE PRINT:

NAME:

ADDRESS &

ZIP CODE

HOME PHONE: BUSINESS PHONE:

FAX PHONE:

E MAIL ADDRESS:

(please write clearly and use proper upper and lower cases)

MEMBERSHIP DUES. . . . . . . . . . . . . . . . . . . . . $40.00

INITIATION FEE . . . . . . . . . . . . . . . . . . . . . . $40.00 NEW MEMBERS ONLY

A $10.00 LATE FEE WILL BE ASSESSED FOR ALL RENEWING MEMBERS IF THEIR DUES ARE NOT PAID BY DECEMBER 31, 2005.

PLEASE MAKE CHECKS PAYABLE TO: MID-JERSEY SKI CLUB

PAY IN PERSON AT TUESDAY MEETINGS Calendar : VFW 6 BROADWAY CLARK, N.J. 07066

PAY BY MAIL TO ASST TREASURER MID-JERSEY SKI CLUB

P.O. BOX 5705

CLARK, N.J. 07066

ATTN: KATHY MANCINI

(Your dues provide you with Membership from November 1, 2005 – October 31, 2006)

or email: mailto:membership@mjsc.org