Renewal of Membership Form

2016 Membership Renewal Form

Member Name: ________________________________________________

Address:  _____________________________________________________

Address (2)___________________________________________________

City, State and Zip_______________________________________________

Telephone:___________________________  Cell: _____________________

E-Mail Address:  ________________________________________________

   
Spouse name ____________________________________________________
   
     Telephone__________________________  Cell:  _____________________

     E-Mail Address:  _______________________________________________

2016 Annual Dues
 (Must be received by 31 January 2016 to be included in the 2016 Membership Roster and 2016 Newsletter mailing list)
         
Full membership ........ ……..………………$35.00
Spouse Membership…..........................……$17.50
Non-resident membership………  ……….. $20.00
     
                      Total Enclosed: ___________________

Please send completed renewal form, and check payable to "Adventurers' Club" to the Club Treasurer:
   Janet M. Miller
   2665 Peter St.
   Honolulu, HI  96816-2013

You can reach Janet at (808) 732-3506; cell (808) 358-9775;    email    miller@hi808.us