|
2011/12 MEMBERSHIP FORM The Stetson Social Club Inc. Aucklands Home of Country Rock |
|
NAME(S): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ EMAIL: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PHONE: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BIRTHDAY: (DAY/MONTH) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MEMBERSHIP: (CIRCLE ONE) $30 SINGLE $50 DOUBLE Membership payment options
Cheques payable to: The Stetson Social Club Inc. Direct Debit to the following account: Westpac Orewa Branch 03 0389 0144511 00 Post to: Stetson Social Club Inc Treasurer Jenny Wildman, 1 Bryn Mawr Place, Albany 0632 Hand to any Stetson Club Committee Member