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Lake Mead Boat Owners Association

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MEMBERSHIP APPLICATION

Please copy/print this application and mail to:
Fred W. Anderson, P.O. Box 60833, Las Vegas, NV 89160 

 

LAKE MEAD BOAT OWNER ASSOCIATION

Membership Application

NAME(S):_________________________________

Birth Date:_________________________________(Month/Day)

Birth Date:_________________________________(Month/Day)

(If Family Membership, names of both adults)

______________________________________________________________

______________________________________________________________

 

ADDRESS:_____________________________________________________

City/State:____________________________________ Zip:___________

Home Phone:________________________________________________

(Work, if applicable)__________________________________________

(Cell Phone)__________________________________

(E-mail Address)______________________________

Signature______________________________________Date:__________

Check to LMBOA enclosed in the amount of $________

* * * * * *Please Fill Out Below, if applicable* * * * * *

Name of Boat::

Type (Make and Length):

Where is your Boat located?

VFH Marine Radio Equipped? Yes No

Special Interests/Comments:

Membership Dues:

(Effective July 1 2002 thru June 30, 2003)

Individual Membership: $20 per year NOTE: ($10 if you join after December 31)

Family Membership: $30 per year NOTE: ($15 if you join after December 31)

Upon completion of membership application, please mail to:

Lake Mead Boat Owners Association

P.O. Box 60833

Las Vegas, NV   89160

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