To become a member of the Dixon Sister Cities Association, please print this page, fill in the application, send it along with your payment to the address indicated.

SISTER CITIES ASSOCIATION

DIXON ILLIINOIS & HERZBERG (ELSTER) GERMANY

MEMBERSHIP APPLICATION

 

Please check type of membership you desire:  


( ) Individual

$10.00

( ) Organization

$25.00

( ) Family

$25.00

( ) Business

$25.00

( ) Senior (65 & over)

$ 5.00

( ) Patron

$50.00 & over

( ) Youth (under 18)

$ 5.00

( ) Contribution (other)

——


Please register membership and name(s):

Name(s) _____________________________________________________

 

Address ______________________________________________________

 

Telephone & E-mail address: _____________________________________

Please indicate below any committee you would be willing to serve on: 


( ) Youth Exchange Program

( ) Membership Committee

( ) Convention Planning Committee

( ) Newsletter Committee

( ) Fund Raising Committee

( ) Speakers Bureau

 

____________________________________ ________________________
Signature of Member, Date

Please return the completed form and membership fee to:

Beverly Shepherd
115 Monroe St. (Make check payable to Dixon Sister Cities Assn.)
Dixon, IL 61021


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