NORTH STAR SEARCH AND RESCUE 
                         Membership Application
Individual yearly membership $ 25.00   UMPI - SAR MEMBERS:$ 10.00
                                       STUDENT FEE:       $ 15.00
**Membership Dues plus $40 for Uniform-shirt
Renewal______NewMember__________          

            *OUTSIDE U.S.-SINGLE MEMBERSHIP: $40.00
            *OUTSIDE U.S.-TEAM MEMBERSHIP:   $150.00
	
Date of Application _____/_____/_____
Date Approved _____/_____/_____
Amount Paid $________.00****


Name:_______________________________________________							
S.S #________/_______/________							
Spouse:_________________________________						
Address:_________________________________________________________						
_________________________________________________________________
							
City:______________________ State:___________Zip:_______________			
Phone Number:(    )____________________






INDICATE CHOICE FOR CLUB MERCHANDISE:
Jackets:   $ 64.00  		Quanity:_______			 Size:_____________			
Caps:      $ 10.00     		Quanity:_______			 Size:_____________			
T-Shirts:  $ 12.00 		Quanity:_______			 Size:_____________			
Patch:     $  5.00		Quanity:_______			 Size:_____________			
Total Merchandise		$_______________		
Total Money Submitted:	        $_______________		
Please Print Form and Mail to:  North Star Search And Rescue
                                1086 Mapleton Road
                                Mapleton, Maine 04757-4508
Make checks or money orders payable to: North Star Search And Rescue.
****Membership dues not refundable after 30 days.