MDAA Membership Form

(Please fill out as completely as possible)

Name_____________________________________________Date_________________

Address________________________________________________________________

City___________________________________State________Zip_________________

Phone(_________)_______________________________________________________

(Please Check one and mail application to specific chapter)

Brainerd
(Brainerd/Baxter Area)
501 Lynndale Drive North
Baxter, MN 56425

East Ottertail
(Perham Area)
104 South Walker Ave
New York Mills, MN 56567

Heartland
(Melrose/Sauk Centre Area)
P.O. Box 296
Melrose, MN 56352

Iron Range
(Hibbing Area)
6016 McNiven Road
Chisolm, MN 55719

Lakes
(Detroit Lakes Area)
P. O. Box 1021
Detroit Lakes, MN 56502-1021

Lake Superior
(Duluth Area)
25 E. Riverside Rd
Esko, MN 55733

Metro
(Mpls/St. Paul Area)
P.O. Box 1875
Burnsville, MN 55337

Central
(St. Cloud Area)
122 - 2nd Street N
Montrose, MN 56363

Mid-State
(Alexandria Area)
605 Carlos Timber Dr
Alexandria, MN 56308

     Morrison County
(Little Falls Area)
15097 Marie Lane                 Little Falls, MN  56345

Paul Bunyan
(Cass Lake/Bemidji Area)
PO BOX 2033
Bemidji,  MN 56619

Northern Voyagers
(International Falls Area)
815 - 19th Street E.
International Falls, MN 56649

Park Rapids
(Park Rapids Area)
17964 119th Ave
Park Rapids, MN 56470

Southern Lakes
(Waseca/Waterville Area)

509 19th Ave NE

Waseca, MN 56093

Valley
(Fargo/Moorhead Area)
4238 39th 1/2 Ave SW
Fargo, ND 58104

West Ottertail
(Fergus Falls Area)
816 S Union Ave
Fergus Falls, MN 56537

1 Year - $5.00 Youth Membership (16 & Under) Date of Birth____________________________
Must fill out for youth membership

 

1 Year - $10.00 Membership

 

Lifetime - $400.00 Age 59 & Under; $300 Age 60 and Older

 

How Paid: (Please Check One) Cash Check #_______


 

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