Membership Application---2008/9
$50.00/Person
$75.00/Couple
Date:_______________________ Amount Paid__________________
Name---Please Print______________________________________________
Address_________________________________________________________
City___________________ State_______________ Zip_______________
Work Phone_________________________________
Home Phone_________________________________
Cell Phone___________________________________
Occupation and Public Office_____________________________________________
e-mail Address______________________________________________________________
Please Make Your Check Payable to “SCGOP” and Return to the Club
Treasurer---Larry White