POP WHITTEN PRO TOUR

MEMBERSHIP APPLICATION

2009/2010

$50.00 ANNUAL MEMBERSHIP

RETURNING MEMBER ___ NEW MEMBER ____

NAME_____________________________________

ADDRESS__________________________________

CITY/STATE/ZIP____________________________

PHONE_____________________________________

EMAIL_____________________________________

HIGH LEAGUE AVERAGE 2008-2009_____

NDBC SANCTION NUMBER__________________

SIGNATURE_______________________DATE________

MAKE ALL CHECKS PAYABLE TO: POP WHITEN PRO TOUR. SEND APPLICATION AND MEMBERSHIP FEE TO: GARY MCKINSEY 17810 JENNIFER LANE, HAGERSTOWN, MD 21740. 301-745-5962