Membership Application

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MTM Membership costs  $25  for Life !

   You will receive:  1 MTM Short sleeve T-shirt,  1 MTM Pin,  1 MTM Patch,  1 MTM Decal
 

* First Name       *Last Name
* Address    * City      
* State/Province * Postal Code       
*  Home  Phone  
 Work Phone    Other Phone        
* Email Address  * SCCA Region 
 Club Affiliation Detroit Region SCCA
Western Mich Region SCCA
Waterford Hills
Other
* License  * Tee Shirt Size
 F & C Training
MTM Seminar
Waterford Seminar
Lake Erie School 
Fire & Rescue School
OJT
Other  
 Medical Training
First Aid 
CPR
EMT
RN
MD/DO
Other

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If you prefer, you may print out the membership application and mail it to us.  Printable



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This page was last updated on 01/01/10 15:53
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