Jerry Hardacre Rick Groves jhard1138@gmail.com rgroves@mabounders.org SECRETARY TREASURER Carol Hardacre Jolly Ann Whitener jhard1138@gmail.com jawhit6@centurytel.net
Pilot’s Name_________________________________________________________ Co-Pilot’s Name______________________________________________________ Street Address_______________________________________________________ City________________________________________State____Zip_____________ Home Phone_______________________Cell Phone_________________________ BOA Number________________E-mail ___________________________________ Birthday: Pilot______________Co-Pilot_____________Anniversary______________ mm/dd mm/dd mm/dd Year of Bounder_____________Model_______________________Length_________ Today’s Date_________________________________________________________ ANNUAL DUES: $5.00 All dues are payable in May of each year. If joining after August 1st, to December 31, dues are $2.50. Please send completed form and check for dues to Carol Hardacre, Secretary, 1905 Winding Way, Anderson, IN 46011. Thank you and welcome to Mid-America Bounders. Jerry Hardacre, President (765)744-1691 |
