Double Faults

2006 MEMBERSHIP APPLICATION

 

 

All applications and checks should be sent/given to ZAC Mawhinney ONLY.

 

Membership year is January 1 through December 31.  2006 dues are $31.15 per member, but if paid before December 31, 2005 dues are $26.15.  Persons joining after June 30 of any year may pay only $16.00 for the remaining term.

 

 

                                                 

Name	Date
Address	State LA       Zip
City
E-Mail
Phone - Home	Phone - Work
Play Preference	Select one of the below: Jefferson Playground on Mondays with Jefferson Playground on Tuesdays with Delta Playground on Thursdays with Little Farms Playground on Thursdays with    Partner

:  

    

 

 

NOT VALID UNLESS YOU ALSO SEND your check PAYABLE TO Double Faults to: 

 

Your Name Your Street City, State, Zip              Zac Mawhinney              1913 Cypress Creek #326              River Ridge, LA 70123

 

 

For Double Faults use only:       Check #                                    Date Received                         .

 

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