Membership Application
Mail
completed application and appropriate fee to: Adirondack Live Steamers, Inc.,
c/o Richard Dean,
===============================================================
I hereby apply for: Regular Joint
Associate Junior (circle one) Membership
Name_______________________________ Email Address_____________________
Address_____________________________ Home Phone_______________________
City________________________________ Work Phone________________________
State_______ Zip Code_______________ Cell Phone_________________________
Name
of Spouse______________________ Birthdate_______/_______/________
Occupation_____________________________________________________________
My
interest in Live Steam is:_______________________________________________
_______________________________________________________________________
Live
Steam equipment, models, etc. owned (complete or under
construction, please give type, scale, gauge,
etc.)________________________________
________________________________________________________________________
________________________________________________________________________
Shop
and other equipment owned and expertise(welding, electrical,
plumbing, etc.)
_______________________________________________________________________
Remarks________________________________________________________________
Please include with your application: Regular Joint Associate
Junior
Initiation Fee $ 50
$ 50/ea. $
0 $ 0
Annual Dues 125 200
40
15
Total Due
with Application $ 175.00 $300.00
$40.00
$15.00
I have read and understand the information
available on the ALS web site concerning ALS
activities and agree to abide by the Constitution, Bylaws,
and Rules of
Steamers. Inc.
Signed_______________________________
Date_______ Amount enclosed $_________
Nominated by (Signature of current
member)_________________________________Date________
*********************DO
NOT WRITE BELOW THIS LINE**********************
$ Amount received____________Date______by________________________________________
Membership Approved YES
NO(reason)_____________________________Date____________