Glacier Lakes Chapter

Glacier Lakes Chapter
Wisconsin

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New Membership Application

NEW MEMBERSHIP APPLICATION
You don’t have to own one to join.
WARNING: You will get the fever!

Name : Spouce:

Address: City: St: Zip:

Phone, Day: Phone, Night:

Email Address: Make Email Address Public: Yes - No

Boat 1: Year: Builder: Model: Lenght: Hull:

HP: Engine: Make: Cyl: Boat Name:

Boat 2: Year: Builder: Model: Lenght: Hull:

HP: Engine: Make: Cyl: Boat Name:

Cost :Annual Adult ACBS...............$45.00 Chapter Affiliation GLACIER LAKES Dues....................$15.00 Total.........................................$60.00	Please Print Print and send remittance to: ACBS, Headquarters 422 James Street Clayton, NY 13624 315-686-2628 FAX (315) 686-2680 E-mail: hqs@acbs.org
Thank you for applying!