Membership Form

SHORELINE SWING MEMBERSHIP

SEPTEMBER 2018 - JUNE 2019

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 9/2018- 6/2019

Signed by staff____________________________________