American Sternwheel Association

Membership Application

(Please print out form--all information supplied will be kept confidential)

NAME: *____________________________________

STREET: *__________________________________

CITY: *____________________ STATE: *___________ COUNTRY:*____________________

ZIP(or postal code): *____________________

PHONE: (______) _____-________

E-MAIL:_____________________________

OCCUPATION:_____________________________

BOAT NAME (If any):_______________________________

Are you interested in someday owning a paddlewheel vessel? Yes:______ No:_____

How did you learn about the ASA?

Web Site:______ A publication:_____ Another person:_____ Other:_________________________

Additional Family Members Included For Membership:

1.__________________________________

2.__________________________________

*Required fields

The primary membership includes 2 issues of the STERNWHEELER magazine and 4 issues of the ASA newsletter. All members are entitled to vote and/or hold office. Dues are $ 20.00 per year for the primary membership and $ 5.00 per year for your spouse or each additional family member. For those OUTSIDE the United States who wish to become members, primary membership dues are $ 30.00 per year in UNITED STATES CURRENCY to help defray the extra cost for mailing.

A check or Money Order should be made payable to American Sternwheel Association and sent to:

American Sternwheel Association, P.O. Box 1482, Charleston, WV 25325