| Clan Graham of the West Founded April 1994 Based in the West to serve Grahams in the West |
| Individual Membership Renewal |
| Please print legibly |
Name: First____________________________Middle_________________Last________________
Street Address:___________________________________________________________________
City____________________________State___________Zip_________________Country________
Telephone ( )____________________Business or Fax__________________________________
e-mail address________________________________________Cell:________________________
Children's Names_________________________________________________________________
Street Address:___________________________________________________________________
City____________________________State___________Zip_________________Country________
Telephone ( )____________________Business or Fax__________________________________
e-mail address________________________________________Cell:________________________
Children's Names_________________________________________________________________
Individual Membership: $15 per year
Family Membership: $20 per year (includes all members of the family under 18)
Associate Membership: $20 per year (for non-Grahams or non-Graham Septs. No voting privileges)
Memberships are for the calendar year and are payable by March 1st of each year. Please make
checks payable to: Clan Graham of the West and mail to the address below.
Family Membership: $20 per year (includes all members of the family under 18)
Associate Membership: $20 per year (for non-Grahams or non-Graham Septs. No voting privileges)
Memberships are for the calendar year and are payable by March 1st of each year. Please make
checks payable to: Clan Graham of the West and mail to the address below.
| Membership type: ______Individual ________Family ________Associate |
| Send Membership Applications to Clan Graham of the West Shanon Roberts 650 Ruby Road Livermore, CA 94550 |
For Official use.........
Clan Graham of the West use only:
Amount Received: $__________
Date Received: ___________
Cash _____ Check_______
Date Posted_________________
Clan Graham of the West use only:
Amount Received: $__________
Date Received: ___________
Cash _____ Check_______
Date Posted_________________
Membership accepted at the ________________________________________games/location
Received by:________________________________________Date____________________
Received by:________________________________________Date____________________
