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MEMBERSHIP APPLICATION
Pilot’s Name___________________________
Co-Pilot’s Name________________________
Street Address_________________________
City__________State____Zip_____________
Home Phone_______________________Cell Phone_________________________
BOA Number________________E-mail _____
Birthday: Pilot______________Co-Pilot_____________Anniversary______________
mm/dd mm/dd mm/dd
Year of Bounder_____________Model_______________________Length________
Today’s Date___________________________
ANNUAL DUES: $5.00. All dues are payable in May of each year.
Please send completed form and check for dues to:
Jolly Ann Whitener, Treasurer
10 Oak Hollow Drive,
St. Peters, MO, 63376.
Make your check payable to Mid-America Bounders.
Thank you and welcome to Mid-America Bounders.
Steve Rittenhouse, President
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MAB Application
