PRINT THIS FORM OR WRITE OUT THE REQUESTED INFORMATION ON A
PLAIN SHEET OF PAPER AND USPS MAIL IT TO:
MICHIGAN CLUB, Box 232, Green Valley, AZ 85614
PLEASE ACCEPT MY CHECK FOR THE FOLLOWING:
Name_______________________________GVR Number____________
Name_______________________________GVR Number____________
Michigan Address_____________________City_________ZIP________
G.V. Address_____________________________________ZIP________
Phone Number: Line #1________________________________________
Phone Number: Line #2________________________________________
Email Address ______________________@_______________________
Email Address ______________________@_______________________
COMPLETE THE FOLLOWING IF YOU ALSO WISH TO MAKE EVENT RESERVATIONS
Dinner Reservations Per Person:
(All reservations add $4 for non-members or guests)
Annual Dues per Person @ $10.00___________ = $____________
December 4, 2024, $ 23.00 X #____________ = $____________
January 2, 2025, $ 15.00 X #____________ = $____________
February 6, 2025, $ 29.00 X #___________ = $____________
March 5, 2025, $ 29.00 X #____________ = $____________
April 2, 2025, $ 29.00 X #____________ = $____________
GRAND TOTAL (including dues and dinners) = $____________