BCAMC 2008 Membership Form Online:

**After completing this form, you will be automatically redirected to payment information as well as the club's mailing address.

Name :
Class :
Phone: (xxx) xxx-xxxx
Email Address :
Confirm Email Address :
Spouse's Name: (if applicable)
Spouse's Class: (if applicable)

Address Line 1:
Address Line 2:
City :
State:
Zip code:

Employer/Occupation:
Phone: (xxx) xxx-xxxx
Spouse's Employer/Occupation:
Phone: (xxx) xxx-xxxx

Please select if this is a new membership or renewal. (Please select one)	New Renewal
Please select your membership level. (Please select one)	Individual - $20.00 Couples - $35.00 Outstanding BCAMC Supporter - $50.00 **
**Please note that the Outstanding BCAMC Supporter comes with optional nametag, newsletter and luncheon recognition
In addition to my club membership, I would like to donate the amount entered to BCAMC:
Total Check: dues + donation = Total
I will pay: (Please select one)	by Mail Online using PayPal

Would you like to be contacted about advertising in our quarterly newsletter or on our website ? (Please select one)	Yes No
I am interested in serving on the following committees:	Bevo Burn Coach's Night Aggie Tip-Off None
Optional Message :	Please feel free to type or copy and paste as much text as you need into this message box.

Please review your entries above before submitting the membership form.