Nebraskaland Council HI-USA

Nebraskaland Council Membership Application

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[    ] Adult Membership (18 - 54 years) - $28                    [    ] Youth Membership (under 18) - Free

[    ] Senior Citizen (55 plus) - $18 *                               [    ] Life Membership (buy at any age) - $250 *

[    ] Organization - Free to non-profit groups *       * = Processed at National - please allow extra time)

Please add $1 for postage. You will receive your membership card valid internationally for one year from the month of purchase.

Name ______________________________ Telephone (    ) ____ - ______ Email ______________

Address ______________________ City ____________________ State ______ Zip Code ______

Birth date ___________________________      [    ] New Member [    ] Renewal [    ] Lapsed Renewal

Optional Survey :
I/We plan to use my/our hostel pass in these locations _____________________________________

I/We first hostelled in ______________________ (city/state/nation) on __________ (approx. date)

I am/We are interested in hostelling because ____________________________________________

I am/We are interested in helping     (check all that apply) ...

[    ] plan / lead bike trips       [    ] plan / lead hostel trips    [    ] clean the hostel    
[    ] host visitors to our area    [    ] Serve on the Board of Directors [    ] ______________

Please print out this page and send it with your check or money order to :

Nebraskaland Council HI-USA                                                         (Adult or youth passes may be
P. O. Box 81827                                                                             purchased from the Hostel Manager
Lincoln NE 68501                                                                            during business hours)
                                                                            Questions regarding Membership? 402 476 0355
Links:
Nebraskaland Council Home Page    Cornerstone Hostel    Want to join our Board ?