Contact Data (Information will be shared only with ASC Chapter 7 club members and used for club-related business) PLEASE PRINT CLEARLY 

 

Name:                                                                                                                                                                         

                                         ^{First                                                                                                                Last}

Mailing Address:                                                                                                                                                          

City, State, Zip:                                                                                                                                                           

Home Phone:                                                                            Cell Phone:                                                                  

Email Address:                                                                                                                                                            

Are you a new or renewing member?                □ New             □ Renewing

Are you a member of the national American Singers Club?                    □ Yes              □ No

 

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Membership Dues Payment Information

 

Associate Membership                                                                                                 □ $25.00

 

ENTER SELECTED MEMBERSHIP DUES PAYMENT FROM ABOVE LIST (Non-refundable)                                                                                                                       $              

 

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Please return payment in the form of check or money order to (payable to ASC Chapter 7, Midwestern American Singers)

 

Midwestern American Singers Club, c/o Edward Medrano 8908 South Yates, Chicago, IL 60617

(773) 750-8691 ● email GoStev7@att.net

 

Membership is by calendar year and runs January 1^st through December 31^st

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