Royal Scottish Country Dance Society

Royal Scottish Country Dance Society
San Gabriel Valley Branch
Membership Application/Renewal Name: __________________________________________________
Address: ________________________________________________
Phone: (Home) ____________(Cell) ____________(Work) ____________
Email: (Home) ____________________(Work) ____________________
Fax : (Home) ____________________(Work) ____________________
Please fill in all items that you wish to be included in the roster. Leave blank any that you wish to be excluded from the roster.

Dues (select one):

_____ $35 annual membership dues (individual primary membership)

_____ $65 annual dues for dual household (two primary memberships)

_____ $10 annual membership dues for member of another branch (supporting membership,

indicate primary branch and membership number: __________________________________)

_____ $16 annual dues for dual supporting (primary branch and membership numbers: ___________________)

NOTE: All membership categories expire on May 31 and include cuebook(s) and one newsletter subscription. Primary memberships have affiliation with the Royal Scottish Country Dance Society (RSCDS) through this branch, and this includes receipt of RSCDS publications. Supporting memberships are only available to those who have RSCDS affiliation through another branch.

Distribution of Materials (other than newsletter) (select one):

_____ By mail

_____ Pasadena class (Doug Macdonald) _____ Culver City class (Pat Grivetti)

_____ Eagle Rock class (Ian Sullivan) _____ Thousand Oaks class (Robb Quint)

_____ South Pasadena class (Anthea Macdonald) _____ Orange County Branch

_____ Los Angeles Branch Demonstration Team _____ Clan MacLeod Dancers

I can help in the following areas:

____ Dance in demonstrations ____ Set up tables and chairs

____ Coordinate an event ____ Help with decorations

____ Print programs and flyers ____ Help with food and refreshments

____ Other: _____________________________________________________________

PLEASE MAIL THIS FORM TO: Registrar, RSCDS-SGVB

Robb Quint

325 Lynn Oaks Court

Thousand Oaks, CA 91320-4760

Questions: Robb Quint (805) 498-2303

_____	$35 annual membership dues (individual primary membership)
_____	$65 annual dues for dual household (two primary memberships)
_____	$10 annual membership dues for member of another branch (supporting membership,
	indicate primary branch and membership number: __________________________________)
_____	$16 annual dues for dual supporting (primary branch and membership numbers: ___________________)

_____	By mail
_____	Pasadena class (Doug Macdonald)	_____	Culver City class (Pat Grivetti)
_____	Eagle Rock class (Ian Sullivan)	_____	Thousand Oaks class (Robb Quint)
_____	South Pasadena class (Anthea Macdonald)	_____	Orange County Branch
_____	Los Angeles Branch Demonstration Team	_____	Clan MacLeod Dancers

____ Dance in demonstrations	____ Set up tables and chairs
____ Coordinate an event	____ Help with decorations
____ Print programs and flyers	____ Help with food and refreshments
____ Other: _____________________________________________________________

PLEASE MAIL THIS FORM TO:	Registrar, RSCDS-SGVB
	Robb Quint
	325 Lynn Oaks Court
	Thousand Oaks, CA 91320-4760
Questions:	Robb Quint (805) 498-2303