MAILING ADDRESS:
Name ____________________________________
Street ____________________________________
City/state/zip __________________ ____ ________-_____
home phone _____-_____-_______ work or cell phone ( )_____-______-____________
(specify
w or c)
email: ____________________________________
Do you have any special skills (legal,
accounting, web design, etc) that you could
use to help CSU in its operations? ____________________________________________
sex: ___ birthday (mo/dy/yr) ___/___/___
SECTIONS:
( ) Running Will you registered
with USATF/NE as a CSU member? Y N
( ) Race Walking Will you registered with USATF/NE
as a CSU member? Y N
( ) Skiing Will you
registered with NENSA as a CSU member? Y N
( ) Orienteering Will CSU be your primary USOF club Y N
DUES: You can sign up for one or more years; just multiply the amount by the number of years. Or, you can sign up for life membership.
YEARLY MEMBERSHIP Basic Adult ($15/$7.50/$22.50) ______ or Junior ($10/$5/$15) ______ Total sections ___ minus 1 -1 = extra sections ___ @ $3/1.50/4.50 ______ TOTAL ANNUAL DUES ______ x Number of Years ___ TOTAL ______
|
LIFE MEMBERSHIP Individual life membership ($200) ______
Total sections ___ minus 1 -1 = extra sections ___ @ $40 ______ TOTAL LIFE DUES ______
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Make out checks to CSU, and send to:
Larry Berman
23 Fayette St
Cambridge MA 02139-1111