SAN LUIS REY DOWNS MEN’S CLUB

APPLICATION FOR MEMBERSHIP 2010

 

ALL INFORMATION MUST BE COMPLETED TO BE ACCEPTED

 

 

Name: _________________________________________________________

 

Address: _______________________________________________________

 

City: __________________________  State: _________  Zip: _____________

 

Day phone: __________________   Evening phone: _____________________

 

Email address: ___________________________________________________

 

Renewal ___   New Member ___  If this is a renewal, is your address label correct? (Y/N) ____

 

 

Please remit $100 to renew membership for 2010,  $105 if paying by Credit Card. 

Renewals after December 15, 2010 are an additional $10 as there is a charge to be reinstated by the SCGA.

 

 

NEW MEMBERS ONLY

 

If you are a new member, are you currently a member of an SCGA affiliated club?

 

Yes_____    No _____

 

If yes, current club name:

 

 

 

 How did you hear about SLRD Men's Club?

 

 

 

 

SCGA # __________  Index _________

 

New Member Dues:  $100 or $105 if Credit Card.   (Club dues plus initiation fees)