APPLICATION FOR MEMBERSHIP

IF ELECTED I WILL BE GOVERNED BY THE CONSTITUTION AND BY-LAWS

OF THE ASSOCIATION

(PLEASE PRINT)

NAME _________________________________________DATE ________________

ADDRESS ______________________________________________________________

CITY _____________________________________ STATE _______ZIP___________

PHONE ___________________________________ DOB _____________AGE______

E-MAIL _______________________________________________________________

NAME OF ENDOSING MEMBER _________________________________________

SIGNATURE OF ENDORSING MEMBER _________________________________

SIGNATURE OF APPLICANT ____________________________________________

ACCEPTED FOR MEMBERSHIP __________________YES _______________NO

MEMBERSHIP EFFECTIVE DATE _______________________________________

NON-REFUNDABLE APPLICATION FEE OF $50.00 IS DUE AND PAYABLE

WITH THIS APPLICATION AT ANY REGULAR MONTHLY MEETING