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Membership Form

SHORELINE SWING MEMBERSHIP

SEPTEMBER 2015 - JUNE 2016

Membership benefits begin at sign-up and end in June

 

 

DATE: __________________

 

NAME:_____________________________________________

 

ADDRESS:__________________________________________

 

___________________________________________________

Town/City State Zip

 

PHONE:____________________________________________

 

EMAIL:_____________________________________________     (please print clearly)

 

Check all that apply:

 

_____ I would like to receive announcements by email

 

_____ I would like to help at the dances as a Swing Shift volunteer for a reduced admission fee of $5

 

 

$10 Membership fee paid by: Check _______ Cash _________

 

Renewal_________New membership ________

 

card issued_______         Google list updated_______

…………………………………………………………………………………………………

 

 

Treasurer's copy

Member Name____________________________________

Date______________

$10.00 Shoreline Swing, Inc. membership dues for the period of 9/2015- 6/2016

 

Signed by staff____________________________________


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