| Newsletter |
| Belgrade Senior Friendship Center |
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Membership Form Belgrade Senior Center, 92 East Cameron Ave., Belgrade MT 59714 Dues are $12.00 per year Date____________________________ Name____________________________________ Address__________________________________ City/State/Zip____________________________ Phone___________________________________ Birthdate _______________________________ Membership: New_____ Renewal_________ Payment: Cash_________ Check________
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The Senior Center has more current information. |
CONTRIBUTIONS
YES, I (We) would like to make a donation in the amount of $_______________
_____My Check is enclosed (payable to BSC)
_____Cash is enclosed
Address: __________________________________________________________________
City: ______________________________________ State: _____________ Zip: ________
I wish to make a gift (please check one)
_____To Support Belgrade Senior Center
_____In Honor of__________________________________________
_____In Memory of ___________________________________________
_____Other______________________________________________________
Please send a memorial card to:
Name___________________________________________________________________
Address _________________________________________________________________
City _____________________________________ State______________ Zip_________
Your gift is tax-deductible to the extent provided by law.