2010 SNRHA MEMBERSHIP APPLICATION

                                                              Date:                                

Voting Member Name                                         NRHA #

Voting Member Name                                         NRHA#

Name                                                                  NRHA#

Name                                                                  NRHA#

Address                                                                          

City                                      State                     Zip

Home phone  (   )                               mobile phone (   )

Email Address:                                                   

Membership Dues:       All voting members must be over the age of  18 (youth CANNOT vote)  Please list all members in the name section and make sure voting members are indicated. Please Indicate with a check mark the appropriate membership category below:

Individual ( over 18 as of January 1)                  $30.00

Family (list all members, indicate 2 voters          $40.00

Partnership (list all officers, indicate voter           $40.00

Youth ( under 18 as of January 1)                     $10.00

Amount Paid                                               $

Paid by check no.                     paid by cash

Please send application with your payment to: SNRHA c/o Kathie Salera -   8525 W La Madre Wy LV, NV 89149     www.SNRHA.ORG