Chicago-Milwaukee Registration Form

Local Chapter Membership               $15.00 Annual Dues
Make Checks Payable To: Chicago / Milwaukee HET Club
Please print and fill out this form  COMPLETELY and mail it along with your payment to:

Tom Beilke
8455 W Castle Island
Chicago, IL 60656
Phone: 773-589-2543

Make sure to include your e-mail address

Name
Street Address
Town, State, Zip code
Home Phone
Cell Phone
Email Address
HET ID #