Dues

Marmarinon Society - Membership Dues Statement

Name:______________________________________

Address: __________________________________

City & Zip Code:___________________________

Telephone: ________________________________

Fax: _______________ E-mail: ____________________________________



Annual Dues:
Year: 20____
Men's____ Women's____
$10.00 per year $5.00 per year



Annual Dues:
Year: 20____
Men's____ Women's____
$10.00 per year $5.00 per year



Past Years Annual Dues:
Men's____ Women's____
$10.00 per year $5.00 per year



Special Donation: __________

Total Amount Included: ____________

PLEASE NOTE. In order to process your dues or donations you MUST print this page with all your information filled in, then mail it to:

Mr. George Stratos
Treasurer
52 Aspen Way
Rolling Hills Estates, CA 90274



Top of Page