Membership Application

Numedalslågen Lag Membership Application

Membership Dues:  Check one below

USA
Single Membership_____ $10 per year or _____ $27 for 3 years
Family Membership_____ $12 per year or _____ $33 for 3 years

CANADA
Please purchase American Money Order when sending funds.
Single Membership_____ $12 per year or _____ $33 for 3 years
Family Membership_____ $14 per year or _____ $39 for 3 years

NORWAY*
Single Membership_____ $15 per year or _____ $42 for 3 years
Family Membership_____ $17 per year or _____ $48 for 3 years

Make checks payable to NUMEDALSLÅGEN LAG,
not to the treasurer:
Fill out this form completely and mail to:
Shirley Sindelar
2256 Eagle Creek Blvd
Shakopee MN 55379

Date ____________________________________________________
Name(s) _________________________________________________
Address _________________________________________________
City_____________________________________________________
State ________________________Zip_________________________
Telephone________________________________________________
E-mail___________________________________________________

Please write down the names of the farms in Numedal from which you descend and the church parishes in which they are located:

FARM NAMES
___________________________
___________________________
___________________________
___________________________

PARISH NAMES
___________________________
___________________________
___________________________
___________________________

*ATTENTION - MEMBERS IN NORWAY:  In order to avoid the huge international money order fees, you may contact Knut Stuvstad at Riegelsbakken 13, 3616 Kongsberg, Norway -- e-mail at stuvstad@online.no.  Knut has access to an American checking account and has offered to help you with this.  You pay him and he will pay Numedalslaget.