Brandeis National Committee - San Fernando Valley Chapter

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NAME_________________________________________________________________
ADDRESS______________________________________________________________
CITY____________________________________STATE______ ZIP_______________
HOME PHONE_______________________________
CELL PHONE_______________________________
EMAIL_________________________________________________________________
SPOUSE'S NAME____________________________________________

    Check one category:

National dues apply from July 1 - June 30.

Make checks payable to Brandeis University/BNC
REMEMBER: Dues are TAX DEDUCTIBLE

Mail your MEMBERSHIP APPLICATION and CHECK to:

For Membership Information contact:
Barbara Kramer 818-789-3386 or eugenekrmr@aol.com
Ruth Fleischman 818-360-2067 or rbybegonia@gmail.com

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