SOFLAMSC Membership Form
AMYA #277
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
AMYA Member #
*
Boat(s) Owned
*
My Products
*
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Family Membership
$
45.00
Adult Membership
$
30.00
Junior Membership
18 or younger
$
5.00
Snowbird Membership
$
15.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
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