Redmond Cycling Club Membership Subscription Form
Individual/Family* Membership Dues: $15 per calendar year
Please complete this form and mail it with your dues to:	Redmond Cycling Club — Membership P.O. Box 1841 Bothell, WA 98041-1841
___ New Membership	___ Renewal	___ Info Change; start date:________
____________________________________________________________________		___ ___ ___
First Name & Last Name	Membership # (first 3 digits in top right corner of the address label)
____________________________________________________________________		(___)_________x___
Address line 1		Daytime phone
____________________________________________________________________		(___)_________x___
Address line 2		Evening phone
____________________________________________________________________		________________
City	State & Zip Code	E-mail address
___ I do NOT want to be listed in the RCC roster.
* One vote is allowed per membership when voting on RCC issues and one copy of the RCC newsletter is mailed for each membership. Use additional copies of this form if multiple family members are to be listed under this membership. All family members will be shown with the same mailing address.