Membership Form
Royal Scottish Country Dance Society
Central Iowa Branch
Name_______________________________________________________________________
Address____________________________________________________________________
____________________________________________________________________
Home Phone_______________________ Work Phone_____________________________
e-mail_____________________________________________________________________
What is your interest in Scottish Country dancing?_________________________
___________________________________________________________________________
Would you be willing to have your name, address, phone number, and
e-mail address in a branch membership directory?___________________________
Would you be willing to help with one or more of the following?
Publicity______ Socials_____ Class Organization______ Board Member______
Book Library_____ Music Library_____ Equip. Maintenance_____ Other_______
Fees: Single: $30.00______ Couple: $50.00______
Payable annually. Fiscal year is from July 1.
Please send check and form to:
Gayle Hoepner, 413 tenth St., Ames, IA 50010
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