Application

OSSA Membership Application
Print out and send in with payment.
OSSA Year: Sept 1st to Aug 31st
Annual Membership Dues
(_) New $25 ------- (_) Renew $25 ------- (_) Business $25

Last Name:______________________________________________
First Name:______________________________________________
Spouse:_________________________________________________
Email:_________________________________________________
Address:________________________________________________
City:____________________________________________________
State/Zip:________________________________________________
Home Phone:__________________Work Phone:_________________
Club Name:______________________________________________
No. of Family Members___________No. of Machines_____________

State Association Dues .........................................$________
Club Dues ............................................................$________
Total Enclosed for OSSA .....................................$________
Donation to Legal Action Fund .............................$________

Local Club Name:__________________________________________
Contact:______________________________Phone:______________
Mail to: Oregon State Snowmobile Association
P.O. Box 435, LaPine, OR 97739
1-888-567-SNOW (7669)
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