MSSLS LLC

C/O Tom Toth

60775 Mound Rd.

Washington, MI 48094

Michigan Small Scale Live Steamers Club Membership Form

Membership Requirements:

Please complete the form below and mail to the MSSLS with your club dues payable

Name: _______________________________________________________

Address: _____________________________________________________

City: ____________________________ State: ______ Zip: ___________

Phone #: ___________________________

E-Mail Address: _______________________________________________

NMRA #: __________________ NMRA Expiration Date: ____________

Personal Web Site (if any): ________________________________________