Stowe Bike Club
			2010 Membership Application
			_____ Individual   $20          ______Family   $35
			Name:  _________________________________________________________
			Address:  _______________________________________________________
			E-mail Address:  __________________________________________________
			City:   ______________________   State:  ____________  Zip:  _____________
			Home Phone:  ___________________________  Work Phone:  _____________
			Additional Family Members:
			Name: ________________________________________________________________________
			Name: ________________________________________________________________________
			Name: ________________________________________________________________________
			Please send this application along with check to:
			Stowe Bike Club
			c/o Dot Helling
			29 East State Street
			Montpelier, VT 05602-3011
			For more information call: Dot Helling at (802) 279-8199, E-mail: ultradot@myfairpoint.net or visit our web site at Stowetimes.org
			visit our website at Stowetimes.org