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Mercer Dusty Loons ATV Club Inc
2019 Annual Membership Application
January 1 – December 31



Name _____________________________________________________________________
Business (if applicable) ____________________________________________________
Address ___________________________________________________________________
Phone ______________________________________
Email _______________________________________
New __________ Renewal __________

Individual Membership $20 ______
One vote at all Mercer Dusty Loons meetings.
Family Membership (up to four people living in the same household) $30 ______
Two votes at all Mercer Dusty Loons meetings.
Business Membership $35 ______
One vote at all Mercer Dusty Loons meetings and a FREE link to your business on the mercerdustyloons.com website, plus a 5 line or 110 character description of your business.
(Please submit on a separate sheet.)

OR

Individual Membership (see above) and a WATVA Membership* $50 ______
Family Membership (see above) and a WATVA Membership* $60 ______
Business Membership (see above) and a WATVA Membership* $85 ______
* The WATVA membership includes quarterly print magazines, access to their e-newsletters (sent as needed) and access to the digital edition of Trail Tales on their website.

Mail to: Mercer Dusty Loons ATV Club Inc, PO Box 26, Mercer, WI 54547 (Make checks payable to Mercer Dusty Loons ATV Club Inc.)

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