Memership Application Silver Strikers
Name _____________________________________
Address____________________________________
City __________________________________________
State__________________________________________
Phone ________________________________________
E-Mail_________________________________________
My area of interest are
( ) All ( ) Atlantic City
( ) Nevada ( ) Riverboat
( ) Colorado Other ________________
( )All ( )$2 ( )$3 ( )$7 ( )$10 ( )$20
( )$28 ( )$40 ( )$200 Other____
Check here if this is an annual renewel ( )Yes ( )No
May we publish the above information in the club roster ( yes ( ) No
SPONSOR NAME_____________________________If none write website
Mail complete application with your first year dues of $10.00 and a one time new member processing fee of $5.00.
Associate membership for spouses is available for an additional $10.00. Make check payable to:
Silver Strikers
% Kevin Pyles
517 Howard Drive
Sierra Vista AZ 85635-1136
email: tazdud@cox.net
