COLORADO RIVER WALKERS MEMBERSHIP APPLICATION

 

 

 

Check one: New _____ Renewal _____.  For renewal please include the year you first became a member.  _______

 

Dues are $10.00 per year for individual or family membership, $20.00 for a two-year membership or $100.00 for a life membership.

 

Type of Membership:          Individual _____ or Family _____

One Year _____ or Two Year _____ or Life _____

 

Name:                     __________________________________________________________

Address:                __________________________________________________________

City:                        __________________________________________________________

State & Zip:           __________________________________________________________

Home Telephone: __________________________________________________________

Work Telephone: __________________________________________________________

Email:                      __________________________________________________________

       

Nametags are available for $15.00 each.

Please print the name exactly as you want it to appear on your CRW nametag:

Name(s) ________________________________________________________________   

________________________________________________________________       

________________________________________________________________            

# of tags:  _______________

 

Amount $ enclosed: ___________________

 

 

 

Please send this form and your check to: