MONROVIA ROCKHOUNDS
Membership Application
Monrovia Rockhounds
P.O. Box 553
Monrovia, CA 91017
NAME________________________________________________________
ADDRESS_____________________________________________________
CITY, STATE & ZIPCODE_____________________________________________________
PHONE #_______________________________ BIRTHDAY ____________
E-MAIL ADDRESS_____________________________________________________
NAMES OF FAMILY MEMBERS___________________________________
Membership Fee _____Single $15.00 _____Family $20.00
Name Badges $10.00 each How many ________
Names ___________________________ _______________________________
You must attend 2 MOROKS Meetings or club events:
Date ___________________________ Date ______________________________
Signature ____________________ Date of Application___________________
Membership Accepted □ Membership Denied □
Date of Board Decision _______________ MOROKS President _______________