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ECTRA MEMBERSHIP APPLICATION
(Membership good thru December 31 of calendar year)
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Email
*
Your email
Full Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Preferred Contact Phone Number
*
Your answer
Type of Membership
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Rookie
Individual
Family
Jr
Honorary
Rookie Rider? If so, list member name
Your answer
Are You an Existing Member? or New
Existing Member
New Member
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ECTRA Member #
Your answer
Family members: Please List ECTRA#, Family Member Name/Junior Date of Birth
Your answer
If name has changed since prior membership please note it here
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