VERMIN Sign-up Form

Name
Street address
 
City
State/Province
Zip
Date
  Optional Fields
Email address (if any)
Nickname (if any)
Phone (optional)
List phone in VERMIN directory? Yes No
Bike info (yr, model, color...)
There are two ways to pay your Join/Pay Dues

1) Print & Mail your completed form, with *check* or *money order* for $25 (US dollars) to:

5125 15th Ave. West
Everett, WA 98203-1670

OR

2) Sign up in person at one of our monthly Meetings (second Saturday of each month) at:

Gators Sports Bar & Grill
21609 84th Ave S, Kent, WA
253-437-0362

* Make check/m.o. out to: VOA - Vermin Chapter
VERMIN

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