RJWC Online Membership Renewal Form 2009-10

It's that time of year again - time to fill out your Membership Renewal Form, and pay your dues. Every member needs to complete the form. The form, together with your dues (for Active and Associate Members) are due by no later than July 10th. As you did last year, you will have the opportunity to pre-pay your financial obligations for the upcoming year.

We will once again be including pictures in the Membership Book. If your picture is not in the book yet, please send a picture to my attention. You can also elect not to have your photo included in the book.

You can mail your form and check(s) to Courtenay Erb, or you can access the form and pay for your dues and obligations online.

Membership Type - Select One

2009/10 Financial Obligations for Active Members Only

Two tickets for the Fundraiser at $45 each = $90

Total Obligation (in addition to dues) = $90

To pay online, click on the link at the bottom of the page (please fill out the information on this form first). You may also mail your check to Courtenay Erb, 3430 McCormack, Brookfield, IL 60513.

Membership Book Photo

Please only check here if you do not want your photo included in the Membership Directory. Otherwise, please submit a photo to the attention of Sandy Briolat at: sbriolat@sbcglobal.net.

Please provide the following contact information:

First Name

Last Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Home Phone

Mobile Phone

Work Phone

E-mail

Birthday (Month & Date)

Spouse Name (if applicable)

Anniversary (Month, Date & Year)

IF CHANGES ARE MADE TO YOUR CONTACT INFORMATION OVER THE SUMMER, PLEASE CONTACT SANDY BRIOLAT AT 708-447-3379 OR sbriolat@sbcglobal.net.

Click here to PAY ONLINE. If link doesn't work, go to www.shop.riversidejuniors.org.

Questions, Comments or Suggestions? Write them here!

Also, please let us know about women you know who may be interested in Juniors by typing their name and contact information below - thanks!

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
Mobile Phone
Work Phone
E-mail
Birthday (Month & Date)
Spouse Name	(if applicable)
*Anniversary* *(Month, Date & Year)*

RJWC Online Membership Renewal Form 2009-10

For information contact Cindy Reynolds Rayfield 708-442-1152 or renewal@riversidejuniors.orgCopyright © 2007 [Riverside Junior Woman's Charity]. All rights reserved. Revised: February 14, 2010

For information contact Cindy Reynolds Rayfield 708-442-1152 or renewal@riversidejuniors.org
Copyright © 2007 [Riverside Junior Woman's Charity]. All rights reserved.
Revised: February 14, 2010