MEMBERSHIP FORM

BUSINESS NAME________________________________

CONTACT______________________________________

ADDRESS_______________________________________

CITY, STATE, ZIP________________________________

PHONE_________________________________________

EMAIL ADDRESS__________________________________

2008 DUES MEMBERSHIP $100.00

TOTAL INCLUDED $_____________

Print Registration form.

Check can be made out to: M.C.A.A.

and mailed to: Rick Martens.

3012 Flintstone St

Mora, MN 55051

Should you have any questions, contact any other board member.