LAKESHORE PEDALERS, INC.
Bicycle Club

Membership Application
(membership is from October 1 to September 30)
  Name
  Address
  City/State/Zipcode
  Telephone
  E-mail address
  Would you like to receive your newsletter via e-mail? Yes      No
   Membership Status New     Renewal
  Membership Type Individual ($15.00 annually)
Family ($20.00 annually)
  If family, please list family members
  Cycling Information Average speed
Typical Ride Mileage
  As a member of the Lakeshore Pedalers Bicycle Club, I would like to assist the club by: Lead a Day Ride
Lead a Weekend Ride
Help with major club event
Present a short program at a club meeting
Program Committee
Newsletter
Publicity Committee
Rides Committee
When you have filled in the blanks above, print this form using your favorite browser.  Please send this application with your check payable to Lakeshore Pedalers, Inc to:

Lakeshore Pedalers, Inc.
1844 North 8th Street
Manitowoc, WI 54220
     


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