Renewing Membership

Brandeis National Committee - San Fernando Valley Chapter



BNC Membership Renewal Form

(Print page, fill it out, mail it
or download and print this .pdf)

NAME_________________________________________________________________
ADDRESS_____________________________________________________________
CITY____________________________________STATE________ ZIP_____________
HOME PHONE____________________________________________
CELL PHONE______________________________________________
EMAIL_______________________________________________________________
SPOUSE'S NAME____________________________________________________

Check one category:
    _____ Single     $60.00
    _____ Couples     $100.00

Annual National dues apply from July 1 – June 30

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

Mail to:

          Sheryl Sager
          5200 White Oak Ave. #22
          Encino, CA 91436
          213-631-8015


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(Galleries from recent events)

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