INTERNET APP
Vermont Horseshoe Pitchers Association-
Membership Application 2012
Name:________________________________________________________________
Address:______________________________________________________________
City:________________________________State:___________Zip:______________
Phone:______________________________Player
Category:___________________
Date of Birth:________________________Pitching
Distance:__________________
Years of Membership:_________________NHPA
#:_________________________
Adult Dues…………….$ 21.00 $________
Senior Discount……….$ -3.00 _________
Junior Dues…………..$ 5.00 _________
NHPA Newsline Magazine
1 year subscription…..$ 12.00 _________
Amount Enclosed _________
Make checks payable to VTHPA
Mail application to: Donna Lewis
97 Trapp Rd.
Huntington VT 05462
For information or questions call: Donna Lewis
VTHPA Secretary
Phone: (802) 434-3155