Polar Bear Grand Tour
2016-2017 Membership
Registration Application

Name
Street
City
State
ZIP
Are you a NEW member? YES NO
Phone
E-Mail
AMA #
Club Name
Current Flight: A B
Join next year's Member of the Week club? YES NO

Please enter any comments you may have:

APPLICATION FEE:
AMA Members $18.00 if paid by August 15th
AMA Members $20.00 if paid after August 15th
Non AMA Members $20.00 if paid by August 15th
Non AMA Members $25.00 if paid after August 15th
Polar Bear Member of the Week fee $20.00

Please make all checks payable to: Polar Bear Grand Tour and send to:

Polar Bear Grand Tour
16 Elizabeth Street
Pemberton, NJ 08068-1116


Important: This form will be sent via E-mail to the Polar Bear Grand Tour.
You will receive a confirmation within a few seconds after submitting the form.

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