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| New_____ Renewal_____ Change_____ | Date _____________________________________ |
| Name___________________________________ | Spouse's Name_____________________________ |
| Address_________________________________ | |
| City____________________________________ | State________ Zip + 4_______________________ |
| Birthdate: M____D____Y_____ (year optional) | Occupation________________________________ |
| Home Phone (_______) ____________________ | Work / Cell (_______) _______________________ |
| e-mail __________________________________ | |
| Please list the class or group with which you dance | _________________________________________ |
| Please indicate here where you might contribute your time and talent: |
| _____Class Manager | _____Membership | _____Publicity | _____Demonstrations | BRANCH USE: |
| _____Musician | _____Socials | _____Hospitality | _____Newsletter | Rec'd____________ |
| _____Teaching | _____Workshops | _____Library | _____Outer Ring | New #____________ |
| _____Other (specify) | _____________ | a) _______________ | ||
| b) _______________ |
| MEMBERSHIP SUBSCRIPTION (ANNUAL) | ||
| ADULT SINGLE (25+): RSCDS $25.00 + Atlanta Branch $15.00 | $40.00 | |
| ADULT JOINT (2, SAME ADDRESS): RSCDS $38.00 + Atlanta Branch $ 26.00 | $64.00 | |
| YOUNG ADULT (18-24): RSCDS $19.00 + Atlanta Branch $ 13.00 | $32.00 | |
| NEW MEMBER AFTER DEC. 31st: RSCDS $12.50 + Atlanta Branch $ 7.50 | $20.00 | |
| JUNIOR ASSOCIATE (Age 17 or youger, no voting privileges or RSCDS publications) | $ 5.00 | $ __________ |
| THE PETRONELLA PAPER - The official newsletter of the RSCDS. Atlanta Branch | ||
| The Petronella Paper is available online at the Branch web site www.mindspring.com/~atlbrnch | ||
| Check here to be notified by e-mail when the new issue of the Petronella is online: | ______ | |
| You may still pay for mail delivery if you wish, as specified below: | ||
| Full year (July 1 - June 30) 6 issues, US delivery (non US delivery - $12.00) | $ 6.00 | $ __________ |
| DONATION TO THE ATLANTA BRANCH MEMORIAL SCHOLARSHIP FUND: | $ __________ | |
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TOTAL PAID: |
$ __________ | |
| Initial here if you are unable, or prefer not to receive Branch communications by e-mail | ______ |
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The fiscal year runs from July 1st to the following June 30th. Membership includes a copy of the RSCDS Annual Bulletin or news magazine, a selected dance publication, a copy of the Local Association Constitution and Rules and notification of General Meetings. A person may vote at General Meetings who has been a member for at least the thirty days prior to the date of the Meeting. The Annual General Meeting and Election of Officers take place in May each year. Please use a separate form for each applicant. Membership in more than one Local Association (Branch) is permitted, but the Member must elect the Local Association (Branch) through which he/she wishes to pay Society subscription fees. Please indicate if there is any information on this form which you do not want published. Keep this lower portion of this application for your records. Amount paid _________ Date _____________ Check #_________ |
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