ISLAND FALLS FREE-WHEELERS A.T.V. CLUB
PO BOX 45
ISLAND FALLS, ME 04747
email: islandfallsfreewheelers@hotmail.com
SUPPORTING BUSINESS MEMBERSHIP FORM
NEW _____ RENEWAL _____
Membership year is July 1st - June 30th Membership Fee is $30.00
Date:___________
Business Name:__________________________________________________________________________
Mailing Address:_____________________ Physical Address if different:_________________________
Town/State/Zip:_________________________________________________________________________
Spouse Name:________________________ Children(under 18):_________________________________
Email (for newsletter):______________________________________ Phone:_______________________
Contact Person:______________________________ Website:___________________________________
Sponsoring Member Club: Island Falls Free-Wheelers A.T.V. Club, PO Box 45, Island Falls,
Me 04747, 207-463-2704
Supporting Business Member is entitled to:
* One copy of each A.T.V. Maine Newspapers * Business listed in each A.T.V. Maine Newspaper
* Business listed on A.T.V. Maine Website * Plaque with tag for each year of membership
* Business listed on Island Falls Free-Wheelers Website
* 2,000 Accidental Death and Dismemberment Insurance for business member, spouse and any
children under 18 living in household.
Make checks payable to: Island Falls Free-Wheelers A.T.V. Club
__________________________________________________________________________________________
A.T.V. Maine Supporting Business Member Receipt
Date:__________________ Fee Paid: $30.00 Paid to: Island Falls Free-Wheelers A.T.V. Club
PO Box 45, Island Falls, Me 04747
Thank You For Your Support