Redwood Empire Swing Dance Club
Membership Form
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Instructions:
 Print this form using your browser print button.
 Fill in the form by hand and mail with check to:
    RESDC, P.O. Box 83, Santa Rosa, CA 95402.

 

O General Membership ($30 per year)
O Youth Membership (21 and under $20.00 per year) 
O  New member     O Renewal    O New address   O New phone      Date:_______________________________

Name:  ___________________________________________________

Street:  ___________________________________________________

City/State/Zip:  ____________________________________________

Home phone: ______________   Work phone _____________________

Occupation: ______________________________________________

E-Mail: __________________________________________________

Birthday:     Month ______________________     Day: _____________    

How did you hear about the Redwood Empire Swing Dance Club?
O Web site: _____________________________
O Friend (who?):  ________________________
O Other: ______________________________
Would you like to be involved on a committee?
O Dance   O Activities  O Entertainment  O Hospitality
O Public Relations   O Newsletter     Membership     Finance
O
By-Laws      O Photography     O Other: ________________

For office use 

Paid by:  Cash or Check;    Amount received: $_____________ 

Membership number ___________________________________

Membership valid from: ___________________ to _______________________

Membership card issued:     Yes     No