Membership Form

Raleigh Bottle Club

The Raleigh Bottle Club is a non-profit organization serving the community.

RBC MEMBERSHIP APPLICATION

                                                              1 year membership $15.00

          Single or Family

 

Name: ________________________________________________________________

 

Address: ______________________________________________________________

 

City:____________________________ State: ________ ZIP ___________________

 

Email Address: ________________________

 

My collecting interest are: _______________________________________________________________________________

 

_______________________________________________________________________________

 

_______________________________________________________________________________

 

_____________________

 

Please make check payable to:  Raleigh Bottle Club

 

Bring you check to the club meeting or mail it to:               Robert Creech

                                                                                                       1309 Hinnant Road

                                                                                                       Selma, NC  27576                                                                                  

How did you learn about the Raleigh Bottle Club:    Newsletter ____________

                                                                                         Member    ____________  

                                                                                         Other         ____________

 

 

 

                                                                                                                                                                                                                2007/2008

If you are interested in joining the club please print this form, fill it out and mail it to the address listed on the form.  If you would like to pay via PAYPAL please send an email stating that you would like to join and we will reply with a PAYPAL invoice.  Please send your email to:  raleighbottleclub@gmail.com .  The total membership fee for payment via PAYPAL is $16.50 to cover fees.