Individual/Family Membership

(MSA) Raffle to

Primary Member Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone

Membership Type

Membership dues include Maine Snowmobile Association (MSA) membership. If you are already affiliated with another MSA club, select "Yes" below.

Are you already an Maine Snowmobile Association (MSA) member through another club?

Yes
No

Name of Other Club

Yes

Individual Membership (Existing MSA Member)
Family Membership (Existing MSA Member)

No

Individual Membership
Family Membership

Family memberships may include spouses and dependent children under age 17.

Family Member's Name

First

Last

Date of Birth

Additional Donation to the Club (Optional)

Donations help support trail maintenance, grooming equipment, scholarships, and club activities throughout the year.

Maine Snowmobile Association (MSA) Super Raffle

Support statewide snowmobiling initiatives and trail advocacy efforts. Participants must be 18 years of age or older and residents of Maine at the time of purchase.

Would you like to purchase raffle tickets?

MSA Super Raffle Tickets

I confirm I am 18 years of age or older and a resident of Maine at the time of this purchase.

Membership Summary

Membership cards will be mailed to the address provided on this application. Please verify your mailing information before submitting.

Membership Agreement

I certify that the information provided is accurate.
I understand that membership dues are non-refundable.

Membership Total

Total

Item Quantity Qty Total

There are no products selected.

Individual Membership (Existing MSA Member) 1 $25.00

Family Membership (Existing MSA Member) 1 $25.00

Individual Membership 1 $40.00

Family Membership 1 $40.00

Additional Donation to the Club (Optional) 1 $0.00

Would you like to purchase raffle tickets? - 0 Tickets 1 $0.00

Would you like to purchase raffle tickets? - 1 Ticket 1 $2.00

Would you like to purchase raffle tickets? - 2 Tickets 1 $4.00

Would you like to purchase raffle tickets? - 3 Tickets 1 $6.00

Would you like to purchase raffle tickets? - 4 Tickets 1 $8.00

Would you like to purchase raffle tickets? - 6 Tickets 1 $10.00

Would you like to purchase raffle tickets? - 12 Tickets 1 $20.00

Subtotal

Total $0.00

Process Payment

Card Number

Expiration Date

Security Code

Card Holder Name

Membership Type

Maine Snowmobile Association (MSA) Super Raffle

Membership Summary

Membership Total

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