DUES RENEWAL NOTICE -2012Time to renew your membership in the 203rd “Houn Dawg” Retiree’s Association, for calendar year 2012. Dues become delinquent on April 31, 2012. Normal dues are $15.00 per year. Lifetime Membership for those over 70 years of age is a one-time fee of $50.00.
Please print your name here________________________________.
My address has changed, (____) YES, (_____) NO, If YES enter address change below.
Street, Route, P.O. Box, etc.________________________________________________________________
City, _____________________, State _____________________, Zip_______________________________
Phone No., if Changed, (_______)(_____________________).
E-mail address if you have one you want to share _______________________________________________
Make checks payable to 203rd “Houn Dawg” Retiree’s Association. Mailing address is 2000 W. 32nd Street
Joplin, MO 64804-0296
For Office use: $_________ Received, Date Received_________, Check No._________ or Cash (_______)
Record posted date__________________________. Received by ________________________________.
If you are behind onyour dues a one year renewal will get you upt to date! No Back dues required!
You can print this form for your use! go to File and Print Preview then select Print and current page.