Name_____________________________________________
Address_____________________________________________________________
City____________________________ State_____ Zip___________
Home Phone #______________________________________
Cell Phone # _______________________________________
E-Mail _____________________________________________________________
Individual to contact in case of emergency ___________________________________ Phone ___________________________
Age ________ Male ____ Female____ Member of NMRA? ________ Do you have a speciality? - electronics, scenery, model making, etc?
___________________________________________________________________ Do you have a particular area of interest in Model Railroading? ___________________________________________________________________ If accepted as a member, I agree to abide by the Rules and Regulations and Standard Operating Procedures of the Chat-N-Chew Choo Modular Railroad Club and to respect the environmental restrictions and local rules and regulations of the event host at all times.
Signed ____________________________________________________________ revised 3-6-08
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