| S*M*A*R*T SOUTHERN CALIFORNIA CHAPTER |
| S*M*A*R*T (Special Military Active Retired Travel) RV Club |
MEMBERSHIP APPLICATION FOR SOUTHERN CALIFORNIA CHAPTER S*M*A*R*T PLEASE PRINT Date:___________________ __________________________________________________________________________________________ Last Name First Spouse First Name __________________________________________________________________________________________ Street City State Zip Code + 4 Digit __________________________________________________________________________________________ Branch of Service Status (active or retired) National SMART # (Who referred you to So Cal) (PLEASE PRINT THE MONTHS, I.E. JULY) __________________________________________________________________________________________ Your Birth Date: Day/Month Spouse’s Birth Date: Day/Month Wedding Anniversary: Day/Mo/Yr __________________________________________________________________________________________ Home Phone Number Cell Phone Number E-Mail Address __________________________________________________________________________________________ Type & Length of RV # Slides and Side RV License # List other S*M*A*R*T chapters you belong to:________________________________________________ I agree when possible to participate in Chapter Activities. Signature:____________________________________________________________Date_______________ DUES ARE $10.00 PER YEAR MAIL THIS APPLICATION WITH YOUR CHECK PAYABLE TO SO CALIFORNIA CHAPTER TO: Suzanne Bradbury – 1174 Concord St., San Diego, CA 92106 Welcome and upon receipt of this application, you will receive a roster and chapter information Date Received:_____________________(Treas.) SCC #_________Assigned by (Secretary) Updated 05 Jan 10 |
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