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Membership Application Form

I/we request membership in the Blue Ridge Metal Detecting Club:

Name: __________________________________

Address: ________________________________

City: ___________________ State: ____ Zip: _______

Phone number: _______________________________

E-mail address: _______________________________

Personal web site address: ______________________

Inclosed is $25.00 for individual membership or $35.00 for couple membership.

Amount inclosed: _____________________

If paying by check, please make it payable to Blue Ridge Metal Detecting Club.

Send completed form to:

Blue Ridge Metal Detecting Club
1984 Stepp Mill Road
, NC 28792