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Fillout and send to the address at the end of form. If you have any questions you can E-mail your questions to JonApsey@Home.Com

 2001 Great Lakes Distance Riding Association

Membership Application

Name:_____________________________________________

Additional Names:___________________________________

Address:___________________________________________

City:__________________ State:________ Zip:___________

Phone: ( ____) _____________ Date:_____________

e-mail:____________________________________________

Junior $5.00 Individual $10.00 Family $20.00

 Please send completed application and amount to:

Jon Apsey Phone: 1-517-349-5344

5130 Okemos

East Lansing, MI 48823-2951

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