ATV Minnesota Membership


                        
                            ATV MN Membership Application & Renewal
                        

                        
Are You Gifting This Membership
			
				
				No
			
			
				
				Yes
			
New_or_Renewal
			
				
				New Membership
			
			
				
				Membership Renewal
			
Membership Number 
If you don't know Membership Number please leave blank
Membership_Type*
			
				
				Business
			
			
				
				Family
			
			
				
				Individual
			
Membership_Term_I*
Membership_Term_F*
Membership_Term_IP*
Membership_Term_GIP*
Membership_Term_IV*
Membership_Term_GIV*
Membership_Term_ICC*
Membership_Term_GICC*
Membership_Term_INT*
Membership_Term_GINT*
Membership_Term_FP*
Membership_Term_GFP*
Membership_Term_FV*
Membership_Term_GFV*
Membership_Term_FCC*
Membership_Term_GFCC*
Membership_Term_FNT*
Membership_Term_GFNT*
Membership_Term_B*
Membership_Term_BP*
Membership_Term_GBP*
Membership_Term_BV*
Membership_Term_GBV*
Membership_Term_BCC*
Membership_Term_GBCC*
Membership_Term_BNT*
Membership_Term_GBNT*
Age 18-59 Lifetime Membership,
Individual or Family and covers kids under 18,

Including 1 Jacket and can purchase an additional Jackets for $100.00
Age 60 an Older Lifetime Membership ,
Individual or Family and covers kids under 18,

Including 1 Jacket and can purchase an additional Jackets for $100.00
Legendary Lifetime Memberships ,
Individual or Family and covers kids under 18,
Includes entrance to two ATVAM events per year ,
Including 2 Jackets and can purchase an additional Jackets for $100.00


  
  


Gift Membership Information


Gift_First_Name* 
Gift_Last_Name* 
Gift_Spouses_First_Name 
Gift_Spouses_Last_Name_if_Different 
Gift_Address*    
                    
                         
                                        
                                        Street Address
                                    
                                        
                                        Address Line 2
                                    
                                    
                                    City
                                 
                                        
                                        State / Province / Region
                                      
                                    
                                    ZIP / Postal Code
                                
                                        
                                        Country
                                    
                    
                
Gift_Email_1
                            
                        
Gift_Phone_1
Gift_Email_2
                            
                        
Gift_Phone_2
Gift_Website 
Gift_Facebook 
Gift_Number_of_people_in_your_family
Gift_Number_of_ATV's_you_own


  
  


Clubs
person you are gifting membership belongs to. This does not pay club dues but lets ATV MN know the clubs they have joined.


Gift_Primary_ATV_Club
Gift_Primary_ATV_Club_Info 
Please type in club name.
Gift_ATV Club_2
Gift_ATV_Club_2_Info 
Please type in club name.
Gift_ATV Club_3
Gift_ATV_Club_3_Info 
Please type in club name.
Gift_ATV Club_4
Gift_ATV_Club_4_Info 
Please type in club name.


  
  


Billing Information


First_Name* 
Last_Name* 
Spouses_First_Name 
Spouses_Last_Name_if_Different 
Company 
Address*    
                    
                         
                                        
                                        Street Address
                                    
                                        
                                        Address Line 2
                                    
                                    
                                    City
                                 
                                        
                                        State / Province / Region
                                      
                                    
                                    ZIP / Postal Code
                                
                                        
                                        Country
                                    
                    
                
Email-1*
                            
                        
Phone-1*
Email-2
                            
                        
Phone-2
Website 
Facebook 
Number_of_people_in_your_family
Number_of_ATV's_you_own
Clubs you belong to:


  
  


This does not pay club dues but lets ATV MN know the clubs you have joined.


Primary_ATV_Club
Primary_ATV_Club_Info 
Please type in club name.
ATV Club_2
ATV_Club_2_Info 
Please type in club name.
ATV Club_3
ATV_Club_3_Info 
Please type in club name.
ATV Club_4
ATV_Club_4_Info 
Please type in club name.
Donation_Option
					
				
Payment
Total
							$0.00
							
						
Credit Card*
					
						Cardholder Name
					
					
						
Card Details