Text Box: Membership Application Please Print All Information Text Box: Application Date __________________ Sobriety Date ___________________ OR Clean Date __________________ OR Start Date _ __________________ Must have at least 30 continuous days Text Box: Dues are $9.00 pre month and are payable in advance, monthly, quarterly or may be paid annually at $99.00 for the year. If dues become more than 60 days delinquent, membership privileges will be suspended. Names are dropped from the membership roster after 90 days non-payment and re-application must be made. Text Box: Donations to the Club over and above the regular amount of the dues are welcome, and are tax deductible, to the extent of the law. Ask at the front desk about equipment/appliance donations. They may be accepted if the Club has use for it, this is also tax deductible. Text Box: The doors are open from approx. 7:00 am to 11:30 pm every day (subject to changes) to provide a place for meetings as well as a place for members to relax and socialize. Please be responsible and clean up after yourself. Text Box: APPLICATIONS MUST BE SUBMITTED WITH AT LEAST ONE MONTHS DUES Text Box: Dues paid through month of __________________ Year ________________ Amount $________________________ Donation $ __________________ Back Please Print this page and bring to the West Broward Club Back
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