MEMBERSHIP APPLICATION

The Chippewa Valley Off Road Bike Association (CORBA) is a volunteer organization established to promote mountain biking opportunities in the Chippewa Valley

CORBA is a chapter of the statewide organization, WORBA WWW.WORBA.ORG

Annual Dues (based upon a calendar year)

$20 Individual / Family

$50 Business / Shop (includes membership for up to three employees)

Membership Year

Name

Address

City, State, Zip

Email

Phone

Additional family

Additional family

Additional family

Business ** name if applicable

Our Policy

It is CORBA’ policy to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disability. No individual will be turned away due to financial need or inability to pay. Please contact a CORBA Board Member for more information on options to "work off" your membership dues through participation in volunteer activities.

Thank you for completing this application and for your interest in becoming a CORBA member!

** Family / Business Memberships – Additional Members

Name

Address

City, State, Zip

Email

Phone

Name

Address

City, State, Zip

Email

Phone

Name

Address

City, State, Zip

Email

Phone

Interests

Volunteers are the life blood of CORBA. Tell us which areas you are willing to become involved with:

Trail Work

Planning Future Activities

Event Support

Advocacy Efforts

Leading Group Rides

Newsletter Production

Leading Skills Clinics

Volunteer Coordination

Special Skills

Summarize special skills and qualifications you have acquired from life experience, employment, previous volunteer work, or through other activities, including hobbies or sports.

Please make checks payable to CORBA and mail to:

Chippewa Off Road Bike Association Inc.

4869 Shellamie Dr.

Eau Claire, WI 54701

Questions? chippewaoffroad@hotmail.com or 715-839-7198

3/06