|
Washington County Chapter |
|
Print and complete this page then mail to the address on the bottom. Request for Membership Application Name:________________________________________________ Address:______________________________________________ City:________________________ State:______ Zip:_________ Phone:(____)__________________ New Member____________ Renewal___________ Family Membership: $25.50 _____________ No. Adults ___________ No. Children __________ Individual Membership: $18.00 _____________ Student Membership: (18 years of age) $15.00 ____________ Senior Citizen: (Age 62 or older) $11.75______________ Signature:_______________________________ Date:_____________________ Print this form, complete it and mail with the appropriate
amount of money in a check to: |