CELL____________________________________________
EMAIL___________________________________________
COMMANDS (DATES IF POSSIBLE PLEASE): ______________________________________________
MEMBERSHIP DUES ARE $25.00.  CHECKS SHOULD BE MADE OUT TO ARIZONA 10-13 ASSOCIATION.  CASH AND CHECKS ARE ACCEPTED AT THE MEETING. OTHERWISE PLEASE MAIL TO:   (NOTE NEW ADDRESS) :         ARIZONA 10-13 ASSOCIATION
 16127 E Ocotillo Drive                  Fountain Hills, AZ 85268-4947
ALL DUES PAYMENTS MUST HAVE APPLICATION ATTACHED! NO EXCEPTIONS PLEASE !


AZ 10-13 MEMBERSHIP/RENEWAL APPLICATION
                                   01-10-2017 through 12-31-2017
PLEASE COMPLETE ALL INFORMATION AS THIS IS USED TO UPDATE OUR FILES, EMAIL LISTS ETC. AND ALLOWS FOR BETTER COMMUNICATION.  THANK YOU! ! !
NAME________________________________________________________________
ADDRESS_______________________________________ Apt#__________________
CITY___________________________STATE_____________________
ZIP____________________________________________
HOME PHONE ____________________________________
FAX____________________________________________
CELL___________________________________________     
E MAIL_________________________________________
DATE OF BIRTH___________________________________
DATE APPOINTED________________RETIRED__________
SPOUSE’S NAME___________________________________