packerland hog chaptermember nat'l h.o.g. number: zip: expiration date of national h.o.g.@...
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PACKERLAND HOG CHAPTERLocal Chapter Information
New q Renewal q
$10.00 Membership FeePlease complete form below for Local Chapter use:
Name:
DOB: Wedding Anniversary: ( )
E-Mail Address:
Mail to: Vandervest Harley-Davidson of Green Bay, ATTN: Kay Kozlowski, Membership. 1966 Velp Ave., Green Bay, WI 54303. 920-498-8822.
CHAPTER USE ONLY: Application Denied ____ . Application Approved ____.
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