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National Modena Club

Membership Application

All Members

The annual dues shall become due and payable on or before January 1st of each year and

must be paid prior to February 1st or membership automatically ceases. Members in arrears shall not be mailed a nom- ination or election ballot that year. However, they may receive a club bulletin and yearbook if dues are paid after Feb- ruary 1st.

Name: (Print)__________________________________________________________

e-mail:_____________________________

Address:

______________________________

City: _________________________

State:______

Zip Code:

__________

Phone: (

)

Reenter e-mail:

__________________

New Members

Anyone who has not been a member for the previous year. Voting privileges will begin

in the second year of membership when dues are paid prior to February 1st of

second year.

Please answer the fol-

lowing four questions.

Do you presently own Modenas?

(circle one)

Yes

No

How many years have you raised Modenas? ______years Do you plan on showing your Modenas at any NMC meets? (circle one)

Yes

No

How did you discover the NMC?

__________________________________________________

Single

(1 vote)

ANNUAL MEMBERSHIP DUES $ 25.00 Junior Age ____ ( 0 vote) (check box) $ 10.00

(18 years old or younger)

Husband and Wife (Include both

(1 vote 1 bulletin)

names above)

$ 30.00

Affiliate Club ( 0 vote 0 bulletins)

$ 25.00

Canada

(1 vote)

$ 30.00

Bulletin options:

Members will automatically receive their color bulletin by

viewing or downloading off the NMC website, with their assigned password. I choose to have a black and white printed bulletin mailed to me. You must check box to receive this option.

Bands

May only be purchased for the following year. Contact Chip Creech for band sales.

Donations (Indicate below if you would like to identify use of donation) $___________

Junior Member or program

Show Special

Bulletin Yearbook Ad (See below)

Sponsor of Patrick Laval color drawings

Other

____________________________

Advertising in NMC earbook and Bulletins

Full Page Interior

$130.00

Half Page Interior

$ 70.00

r Quarter page interio

$40.00

Full Page Inside front cover

$ 250.00

Full Page Inside back cover

$200.00

Double Full Page Interior

$250.00

Double Page Interior at fold

$350.00

All ads for one year

Send this form with check to:

NMC Sec./ reasurer Chip Creech P.O. Box 2126 Sumte , SC 29151

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