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Membership Change Form
(To print only the information needed, please highlight, copy and paste to your own word processing program.)
Membership Change Form
Date: ______________ Change: ______ Add: _____ Delete: ______ Member submitting change form: __________________________ Club: __________________________ Member requiring change: __________________________ Address: ____________________________________ City: _________________________ Zip________ Phone: ______________________ E-mail address: ______________________
Please mail this form to the LASRDF Secretary or Treasurer _________________Do not write below this line _______________ Officer receiving form:___________________________________ Copy to Treasurer: ___ Copy to Secretary: __ Copy to Insurance Chairman: ___
3/26/2009
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All LASRDF Dances, Lessons and Meetings are held at the LASRDF Dance Center 2305 PR 7330 (120th Street - 1 block East of University) Lubbock, Texas
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