Membership Application 

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NOTE:  Any new paid memberships beginning October 1 are automatically enrolled for the full upcoming year. If joining in the middle of the year, prorate dues at 50/month single, or $1/month family.
Date:  
_____ Self only ($6/year) _____ Self & Family ($12/year)
Name  
Street Address  
City, State, Zip  
Home Phone  
Work Phone  
Email address  
Birth Date (Day, month only; for newsletter)  
HOW DID YOU HEAR ABOUT ALL WEATHER WALKERS? (Please circle all that apply)
_____ Walking event _____ Health fair
_____ Internet/online _____ Newspaper
_____ Friend _____ Other ________________
 

All Weather Walkers
P.O. Box 241
Vancouver, WA 98666-0241
Jan Breneman, Webmaster