AZ 10-13 MEMBERSHIP/RENEWAL APPLICATION
01-10-2019 through 12-31-2019
PLEASE COMPLETE ALL INFORMATION AS THIS IS USED TO UPDATE OUR FILES, EMAIL LISTS ETC. AND ALLOWS FOR BETTER COMMUNICATION. THANK YOU! ! !
NAME________________________________________________________________
ADDRESS_______________________________________ Apt#__________________
CITY___________________________STATE_____________________
ZIP____________________________________________
HOME PHONE ____________________________________
FAX____________________________________________
CELL___________________________________________
E MAIL_________________________________________
DATE OF BIRTH___________________________________
DATE APPOINTED________________RETIRED__________
SPOUSE’S NAME___________________________________
CELL____________________________________________
EMAIL___________________________________________
COMMANDS (DATES IF POSSIBLE PLEASE): ______________________________________________
MEMBERSHIP DUES ARE $25.00. CHECKS SHOULD BE MADE OUT TO ARIZONA 10-13 ASSOCIATION. CASH AND CHECKS ARE ACCEPTED AT THE MEETING. OTHERWISE PLEASE MAIL TO: (NOTE NEW ADDRESS) : ARIZONA 10-13 ASSOCIATION
16127 E Ocotillo Drive Fountain Hills, AZ 85268-4947
ALL DUES PAYMENTS MUST HAVE APPLICATION ATTACHED! NO EXCEPTIONS PLEASE !
Copyright © 2018 The Arizona 10-13 Association - All Rights Reserved.