Rick Groves Joe Nash rgroves@mabounders.org nash62234@yahoo.com SECRETARY TREASURER Kathy Groves Jolly Ann Whitener kgroves@mabounders.org 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. Please send completed form and check for dues to Kathy Groves, Secretary, 7160 W. Sacramento Drive, Greenfield, IN 46140. Make your check payable to Mid-America Bounders. Thank you and welcome to Mid-America Bounders. Rick Groves, President (317) 501-6169 |
