Passing on the Tradition
Support Group
2008 Membership and Sponsor Application Form Date ___/___/___
All memberships
are for one year (Jan.1 through Dec.31)
Please Print the following information
Address:
________________________________________________________
City:
______________________________ State: ______ Zip. ______________
Phone
Number (______) ______-___________
Type of
Membership (Please check one)
Individual
or Family $10.00 ____
Club & Organization Affiliate $25.00 ____
I would like to volunteer to be my States Support Group
Representative ____
Type
of Sponsorship
Individual
or Grant Sponsorship $___________
Small
Business Sponsorship $250.00 _____
Corporate Sponsorship $500.00 _____
Make
Membership payment payable to Support
Group (Membership)
Make
Sponsorship payment payable to Support
Group (Sponsor)
Send Check or
Money Order and Completed 2008 Form to,
Support Group
1035 Doe Haven Rd.
Ekron Ky. 40117