Membership Application
Form
|
July 1,
______
Year
|
to
|
July 1,
______
Year
|
NEW ____ RENEWAL ____
NAME
______________________________PHONE # _____________
ADDRESS__________________________________________________
Postal Code _____ ______
E-mail __________________________
Committee
Community
Interest______________________Participation Yes___ No ___
Family
Interest___________________ Date _____________________
Type of membership,
Individual-$10.___ Family-$20. ___ Life-$100. _____
Annual Corporate membership
$500. _________