Address:________________________________________________________

City:______________________________State:_________ Zip:_____________

Home phone:______________________ Work phone:_____________________

Date:____________        Email:________________________________________

You may post my name, phone & email address on the RATS website (  ) Yes (    ) No

IF THIS IS A FAMILY MEMBERSHIP:
Spouse (name and birthdate):_________________________________________

Children (name and birthdate):_________________________________________

________________________________________________________________

Biking Preference (check all that apply):
( ) Mountain
( ) Leisure
( ) Road Racing
( ) Centuries
( ) Touring

ANNUAL FEES: Student...$5, Individual...$10, Family...$15
(half price after July 1st)

Return this form and fees to:
Rolla Area Touring Society
20300 County Road 4310
Salem, MO 65560

(573) 265-6157   
BobNNancy2@aol.com
www.rollanet.org/~bikerats