COLORADO RIVER WALKERS MEMBERSHIP APPLICATION
Check one: New _____ Renewal _____.  

For renewal please include the year you first became a member.  _______

Dues are $10.00 per year for individual or family membership, $20.00 for a two-year membership or
$100.00 for a life membership.

Type of Membership:          Individual _____ or Family _____

                                      One Year _____ or Two Year _____ or Life _____

Name:                       __________________________________
Address:                   __________________________________
City:                          __________________________________
State & Zip:              __________________________________
Home Telephone:     __________________________________
Work Telephone:     __________________________________
Email Address:         __________________________________

Name tags are available for $15.00 each.
Please print the name exactly as you want it to appear on your CRW name tag:

Name(s) ________________________________________________________________   
          ________________________________________________________________
          ________________________________________________________________

# of tags:  _______________

Amount $ enclosed: ___________________

Please send this form and your check to:

Sam Harris
1
702 Pheasant Roost
Austin, TX  7875
8