MADRE 2010 MEMBERSHIP APPLICATION

Please provide a self-addressed stamped envelope
so we may return your membership card to you.

Name(s): ______________________________________

Address: ______________________________________

_____________________________________________

City/State/Zip___________________________________

Phone (Home): _(____)___________________________

Phone (Work): _(____)____________________________

Email: ________________________________________

Please indicate whether or not you wish to receive the newsletter by mail or e-mail ________________________________________ (if you do not indicate your choice, the newsletter will be e-mailed to you.)

Circle Membership Type:      NEW     RENEWAL

Total enclosed @ $20 each ________________________

Do you wish to become a Madre volunteer? Yes No

Are you available weekdays? Yes No

Evenings? Yes No and/or Weekends? Yes No

Mail this application and enclose your check
made payable to the San Diego Madres to:
San Diego Madres
ATTN: Membership
P.O. Box 600113
San Diego, CA 92160-0113

The Madres is a charitable not-for-profit organization formed for the public benefit. Donations are tax deductible according to the full extent of the law. Each individual should check with his/her financial adviser for deductibility.

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