MDAA Membership Form

[merkman]

MDAA Membership Form

(Please fill out as completely as possible)

Name_____________________________________________Date_________________

Address________________________________________________________________

City___________________________________State________Zip_________________

Phone(_________)_______________________________________________________

(Please Check one and mail application to specific chapter)

Brainerd

225 1st Street

Randal, MN 56475

East Ottertail

(Perham Area)

36195 528th Ave

New York Mills, MN 56567

Heartland

(Melrose/Sauk Centre Area)

P.O. Box 296

Melrose, MN 56352

Iron Range

(Hibbing Area)

6016 McNiven Road

Chisolm, MN 55719

Lakes

(Detroit Lakes Area)

P. O. Box 1021

Detroit Lakes, MN 56502-1021

West Central

20451 Hwy 9 N.E.

New London, MN 56273

Metro

(Mpls/St. Paul Area)

P.O. Box 1875

Burnsville, MN 55337

Central

(St. Cloud Area)

122 - 2nd Street N

Montrose, MN 56363

Mid-State

(Alexandria Area)

605 Carlos Timber Dr

Alexandria, MN 56308

Morrison County

(Little Falls Area)

15867 93rd St.

Little Falls, MN 56345

Paul Bunyan

(Cass Lake/Bemidji Area)

PO BOX 2033

Bemidji, MN 56619

Northern Voyagers

(International Falls Area)

815 - 19th Street E.

International Falls, MN 56649

Park Rapids

(Park Rapids Area)

17964 119th Ave

Park Rapids, MN 56470

Southern Lakes

(Waseca/Waterville Area)

11261 245th St. W.

Morristown MN 55052

Northern Lakes

(Grand Rapids Area)

24004 State Hwy 46

Deer River, MN 56636

West Ottertail

(Fergus Falls Area)

816 S Union Ave

Fergus Falls, MN 56537

1 Year - $5.00 Youth Membership (16 & Under) Date of Birth____________________________

Must fill out for youth membership

1 Year - $10.00 Membership

Lifetime - $400.00 Age 59 & Under; $300 Age 60 and Older

How Paid: (Please Check One) Cash Check #_______

[Gordie]

thanks merk