Class "A" Club Membership Renewal form for Year 2008

Dues to be a voluntary donation $1.00 per active member with a limit of $500.00 per club/minimum of $30.00

Name of Club: ______________________________

Address: ___________________________________

City/State/Zip: ______________________________

Website Address: ____________________________

E-mail Address: _____________________________

President Name: _____________________________

Address: ___________________________________

City/State/Zip: ______________________________

E-mail Address: _____________________________

Phone: _____________________________________

Secretary Name: _____________________________

Address: ___________________________________

City/State/Zip: ______________________________

E-mail Address: _____________________________

Phone: _____________________________________

Treasurer Name: _____________________________

Address: ___________________________________

City/State/Zip: ______________________________

E-mail Address: _____________________________

Phone: _____________________________________

Delegate #1 Name: ___________________________

Address: ___________________________________

City/State/Zip: ______________________________

E-mail Address: _____________________________

Phone: _____________________________________

 

Delegate #2 Name: ___________________________

Address: ___________________________________

City/State/Zip: ______________________________

E-mail Address: _____________________________

Phone: _____________________________________

How often does your club have meetings? Where, What time (3rd Tuesday of Month etc.?) ______________________________________

What is the average membership of your club, include nonactive members _________