South River City Citizens Membership Form



South River City Citizens (SRCC) membership form (revised November 2012)



Membership Levels:

___________ Single $20 for 1 year ($35 for 2 years in advance, $50 for 3 years in advance)

___________ Family $35 for 1 year ($65 for 2 years in advance, $95 for 3 years in advance)

Additional donation to SRCC General Fund $_______________

Date of dues payment:_________________________________________



Name(s):________________________________________________________________________

Address: _______________________________________________________________________

Telephone:______________________________________________________________________

E-mail: ________________________________________________________________________

Send check made payable to SRCC, along with completed form, to:

SRCC
Attention: Treasurer
P.O. Box 40632
Austin, TX 78704