2010 SBRGA Membership Renewal This form is for renewals only.  Please complete and return this form with your dues payment. Thank you! Please PRINT clearly

     Renewing member(s) name: ________________________________________________

     Mailing address: ________________________________________________________

     City: _____________________________ State: ________ Zip: __________________

     Evening phone number: _________________ E-Mail address: _______________________

- Please note: Your phone number and e-mail address will only be used for Club purposes of announcements and notifications. We will keep this info private.

 Work party hours worked in 2009 (max 15 hrs):

                                           ___ x $2.00 = $ ______ deducted from your 2010 dues renewal rate. 
                                                                                                                             - or -
                                                         ___ I worked 100+ hours in 2010 and qualify for 1 year free renewal.
                                                                                                         (Please note hours will be verified.)

Renewal rates:                  __ Single regular membership: $64.00
                                           __ Junior membership (added to above): $1.00
                                           __ Family membership (Parents and their dependents under age 18): $96.00
                                           __ Life membership (for those who qualify) renewal: $1.00

           Renewal fee: $ _______ - Work hour credit (if any): $  ________ = Total renewal: $ _________
                                                                                                                         

                                                                                                             Total enclosed: $ __________