WOMEN'S SENIOR/MASTERS RACQUETBALL ASSOCIATION

MEMBERSHIP/CONTRIBUTION FORM

SUPPORT WOMEN’S RACQUETBALL!!!

Become a member of the Women’s Senior/Master Racquetball Association. Complete the form below and return it with your check made payable to the “Women’s Senior/Master Racquetball Association”. You will receive a member’s book that is updated every two years with all the current members. You will also receive a periodic newsletter informing you of upcoming tournaments, past tournament results and other ongoing racquetball activities. Your contribution enables the WSMRA to continue to run and promote the annual Women’s National Senior/Masters Tournament and reach as many women’s senior players as possible.

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· Yes, I want to help support Women's Senior/Masters Racquetball. Please add me to your mailing list. Enclosed is my contribution of:

__$25 __$20 __$15 __$10 other_______

• ____ I have made a past contribution but I would like to make an additional contribution. I am already on your mailing list. Amount $_______

Name:_____________________________________________________________

Address:____________________________________________________________

City, State, Zip: _______________________________________________________

Home Phone: _______________________ Work Phone:_______________________

Date of Birth: _____________________

Email (please print)___________________________________________________

Comments, Suggestions:_______________________________________________

__________________________________________________________________

__________________________________________________________________

Please send to:

Nancy Kronenfeld

Professional Insurance Producers

1420 Renaissance, Suite 304

Park Ridge, IL 60068