National Council of "56" Clubs
Associate Member Membership Form
Name of Associate Member __________________________________
________________________________________________________
CONTACT PERSON
_______________________________________
Address_________________________________________________
________________________________________________________
________________________________________________________
Phone_________________________ Fax______________________
Online Computer ID#_________________________________________
National Council Annual Associate Member Dues $100
Make Check Payable to:
National Council of "56" Clubs
and Mail to:
National Council of 56 Clubs
Box 31
New Hartford, CT 06057
