APPLICATION FOR MEMBERSHIP

Vein Mountain Recreational Miners Club
251 Lucky Strike Drive
Marion, NC 28752
(828) 738-4893

I would like to join the VMRC and take advantage of the mining, prospecting and
discount privileges. I have read and agree to abide by all club rules as described
to me at the time of receiving this application.

VMRC Membership: $100.00
Monthly Dues: $20.00
Total Amount Paid at Time of Entry: $_____ OR $340.00 1st Yr.
(Make checks payable to VMRC)
Please print legibly:
Applicant?s Name: _________________________________________D.O.B.___________
Wife?s Name: _________________________________________D.O.B.___________
Address: ______________________________________________
                (Street)
              ______________________________________________
              (City)          (State)          (Zip)
Date: _____________     Phone:(      )____ -______
Applicant's Signature: _________________________________________
I have read the rules and regulations and
agree to abide by them while on club properties.
How did you hear about the Vein Mountain Recreational Miners Club?
________________________________________________________________
(If club member, please give name)
Membership ID Number: _________

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