State: _________________________________Zip Code___________________________________
Email Address: ________________________________________________________________________
Phone Number: Home:________________________ Cell: ______________________________________
Vehicle Make: _____________________ Model: __________________ ATV [ ] UTV [ ]
Individual/Family Member $20.00 [ ] $_____________
Business Member $40.00 [ ] $_____________
Map Ad (Includes Business Membership) $150.00 $_____________
(Please include a camera ready or printable proof of your ad)
Double Map Ad $ 200.00 $_____________
Total Enclosed: $_____________
Please use my map ad that was on the map last season. Please Check [ ]
Please Check [ ] I understand that by joining the St. Germain ATV Club Inc. I will abide by all the rules
and bylaws of the club. I also agree to follow all State of Wisconsin ATV laws and regulations, and that I will
Signature: _________________________________________________________ Date: _______________________
Membership dates are from May 1st through April 30th of each year.
Please cut and paste this application form, print it, and mail it with your check for the proper amount to:
St. Germain ATV Club Inc.
PO Box 161
St. Germain WI 54558.