SANDPIPERS SQUARE DANCE CLUB
Membership Application
Date:__________________________________________
Last name _____________________________________
His First name __________________________________
Her First name __________________________________
Phone Number __________________________________
E-mail address__________________________________
Mail Address:
City___________________________________________
State__________________________________________
Zip Code_______________________________________
His Birthday____________________________________
Her Birthday___________________________________
Anniversary___________________________________
Membership in the Sandpipers Square Dance Club is hereby requested. If accepted, I / we agree to abide by the club rules and support the club activities. We agree to pay a one time initiation fee plus club dues semi-annually in advance. Payment of dues entitles me / us to attend all regular club dances for that half-year. Dues are payable at the time of initiation and then on the first of the months of January and July.
FEES:
One-time initiation fee: $15 each.
Semi-annual dues: $30 for individuals and $60 for couples. (The dues are pro-rated @ $5 / month if you join in the middle of a half-year term. Any excess will be applied to your next semi-annual dues.)
Fee type
|
Rate
|
Multiply by # of applicants
|
Total fee
|
Initiation fees
|
$15
|
X ( )
|
$
|
Semi-annual dues
|
$30
|
X ( )
|
$
|
 |
|
Total enclosed:
|
$
|
I / We understand the initiation fee is to cover the cost of insurance, visitation badges, etc. Dues for the Graduates of the Sandpipers classes will start the first of the month following graduation. All other applicants will promptly pay the prorated per monthly dues for the half-year of their acceptance. Acceptance as a member is not complete until dues are paid. I / we understand that special dances are not included in the dues.
His Signature__________________________
Her Signature _________________________
********** MEMORANDUM OF BOARD ACTION *********
Date:__________________
[____] Board Approved
[____] Board Denied, Initiation Fee Returned
For the Board of Directors:___________________________