Minnesota senior sports association
501c3 non-profit Minnesota corporation
APPLICATION FOR MEMBERSHIP


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Last Name                                             First Name                                                   Middle Initial

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Address

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City                                                        State                                                            Zip Code

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Home Phone                                         Work Phone                                                Mobile

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EMail Address                                                                                                           Fax

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Date of Birth (mo/day/yr)

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Occupation

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2 Yr. Membership ($25)                    5Yr. Membership ($50)                      Lifetime Membership ($100)

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Signature                                                                                                      Date

​Nominate a deserving senior athlete or team for the 2025 Hall of Fame!
Click Here for the nomination form.