Join

Downtown Coaches Club

Membership Application

Print this form on your computer, attach a check (made payable to "Downtown Coaches Club"), include a self-addressed stamped envelope, and send to:

Downtown Coaches Club, PO Box 4765, East Lansing MI 48826-4765

Name: Circle one: New member / Renewal

Address:

City: State: Zip:

Email address (please print VERY carefully):

Home phone: ( ) Fax: ( )

Business phone: ( ) Type of business:

Circle: Yes / No - I can offer a discount to Club members... let’s discuss.

Circle: Yes / No - I can provide a raffle prize.

Annual Dues - $30 Individual, $40 Family, $200 Corporate (includes up to four names... $30 for each additional Corporate member beyond four)

Names of Family Members or Corporate members:

1. 3.

2. 4.

Name Badge(s) (optional) at $12.50 each (Show me a sample)

1. First and Last name: Year joined Club:

2. First and Last name: Year joined Club:

3. First and Last name: Year joined Club:

4. First and Last name: Year joined Club:

Total Annual Dues
$

Total Name Badges ($12.50 each)
$

Total amount enclosed
$

Comments / Questions:

www.dtncoaches.org

Name:	Circle one: New member / Renewal
Address:
City:	State:	Zip:
Email address (please print VERY carefully):
Home phone: ( )	Fax: ( )
Business phone: ( )	Type of business:
Circle: Yes / No - I can offer a discount to Club members... let’s discuss.
Circle: Yes / No - I can provide a raffle prize.
Annual Dues - $30 Individual, $40 Family, $200 Corporate (includes up to four names... $30 for each additional Corporate member beyond four)
Names of Family Members or Corporate members:
1.	3.
2.	4.
Name Badge(s) (optional) at $12.50 each (Show me a sample)
1. First and Last name:		Year joined Club:
2. First and Last name:		Year joined Club:
3. First and Last name:		Year joined Club:
4. First and Last name:		Year joined Club:
Total Annual Dues		$
Total Name Badges ($12.50 each)		$
Total amount enclosed		$
Comments / Questions: