Member Dues Renewal Form

JUNIOR LEAGUE OF CENTRAL & NORTH BREVARD
240 Parnell St.
Merritt Island, FL 32953
321-453-5718
Member: ____________________________________________________

Address: ____________________________________________________

E-mail: ______________________________________________________

Phone: ______________________________________________________
***Our files need updating. Please fill out form with current contact information. Please include e-mail address so we may send the League Launch via e-mail to save $ and the environment.

2011-2012 Dues
Due by May 1, 2012
Late Payment fee of $25 applies beginning June 1, 2010
Please make checks payable to JLCNB and mail to address listed above

Active resident/non resident Dues = $125 $________
Active Sustainer = $175 $________
Sustainer resident/non resident Dues = $100 $________
Sustainer Emeritus Dues (over 80 by April 30, 2010) = $0 $_______

TOTAL $________

Please return top portion with your payment
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Please keep this portion for your records:
2010-2011 Junior League of Central & North Brevard dues $________
Cygnet House Group Foster Care Home Contribution $________
Paid On: ________
Paid By: Check#________

Special Thanks…

A big thanks to everyone who helped out with this year’s Kids in the Kitchen! To Submit special Thank Yous to be included in this section, send an email to the League Launch editor. LeagueLaunch@yahoo.com

Volunteer Hours

Please submit your volunteer hours worked to LeagueLaunch@yahoo.com. Thank you for all that you do for the community and the League! We wish to acknowledge your volunteer efforts, so send us where you volunteered recently, a picture if you have one and a paragraph about your experience.