Membership Form

Send payment to:

Angela Rule, Treasurer
P. O. Box 376
Gatesville, NC 27938

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Address________________________________
City______________State____Zip___________
New Member O Renewal O (Check one)

Name__________________________________
Address________________________________
City______________State____Zip___________
New Member O Renewal O (Check one)

Name__________________________________
Address________________________________
City______________State____Zip___________
New Member O Renewal O (Check one)

Name__________________________________
Address________________________________
City______________State____Zip___________
New Member O Renewal O (Check one)

Number of single Memberships _______@ $15.00 per year (each)

Family Memberships (same household)________@$25.00 per year

Total___________________________________