Club Membership Application East Montpelier Gully Jumpers P.O. Box 75 East Montpelier, VT 05651 www.gullyjumpers.com ————PLEASE PRINT/TYPE CLEARLY———— Club/Grooming Donation First Name Middle Initial Last Name PO Box or House Number and Full Street Address, etc. City/Town State Zip Code Telephone Email ————PLEASE PRINT/TYPE CLEARLY————
