Brandeis National Committee - San Fernando Valley Chapter



New  Membership

 


Renewing Membership | New Membership | Getting Involved


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Brandeis National Committee - San Fernando Valley Chapter

NEW MEMBERSHIP APPLICATION

Please print this and PRINT legibly


Ms Mrs. Mr. Dr. NAME______________________________________________AKA_______________
ADDRESS______________________________________________________________
CITY____________________________________STATE______ ZIP_______________
HOME PHONE______________________________FAX________________________
EMAIL_________________________________________________________________
CELL____________________________SPOUSE'S NAME______________________

_____Yes, I want to join Brandeis National Committee.

    Check one category:

_____ Regular $ 60.00
_____ Gold $ 85.00
_____ Sustaining $125.00
_____ Couples $100.00
_____ Associate $ 15.00

Annual National dues apply from July 1 - June 30.

Make checks payable to Brandeis National Committee [BNC]
REMEMBER: Dues are TAX DEDUCTIBLE

For mailing information, contact:

A – L
Idelle Thaler
17150 Burbank Blvd. #39
Encino, CA 91316
818 501-6343
eugenekrmr@aol.com
M - Z
Naomi Javitz
3541 Green Vista Dr.
Encino, CA 91436
818-783-5419
naomijavitz@brandeissfv.org

 

THANK YOU
for becoming a member of the Brandeis National Committee (BNC)
and for your contributions