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2008 CLUB MEMBERSHIP
Please print and fill out this page, then mail with your Check or Money Order payable to LSKC to:

Buddy Bush , LSKC Treasurer
13619 Keneva Dr
Cypress, TX 77429

Name(s):    ________________________________________
                  ________________________________________


Address: ________________________________________

             ________________________________________


City:       ________________________________________


State/Zip:  ________________________________________

e-mail address: ____________________________________

Home Phone:  ____________
Day Phone:     ____________

 

Do you have any special needs at this time?

 

Dues Level (please check one):                   Date: _____________
    Individual      $25  ______

    Family           $25  ______

    Corporate     $100  ______  (Includes business card ad placement in newsletter & website)


If you have any question, please contact the Treasurer by email or at 281 257-8366.