OFFICERS AND DIRECTORS
A non-profit club dedicated to the promotion of polka music. Your participation as a member is most welcome and will be much appreciated.
Membership Application
Please complete this application (one for each person) and return to:
Membership dues $8.00 per person per year. Junior members (age 17 and under) $3.00 per person per year.
Name____________________________________ Todays date _________Address_________________________________________________________City_______________________________State_____Zip+4______________e-mail __________________________________Phone number (________)__________-__________
Enclose check payable to St. Louis Metro Polka Club
Signature of Applicant _____________________________________________________
Signature of Sponsor _(member in good standing)_______________________________________
Yes _____ You may publish my name, address and telephone number on a membership roster.
No _____ I do not wish to have my name, address and telephone number on a membership roster.
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Page last updated August 13th
