Comus club

2009-10 MEMBERSHIP ENROLLMENT and RENEWAL FORM

 Please print this form, fill out completely and mail with $600 dues to: 

Comus Club

C/O Larry Quinlivin

2327 North Shore Road

Bellingham, WA 98226

 

Member Name____________________________________________________________

                                  First                                  Last                                      

Spouse Name____________________________________________________________

                                  First                                 Last                                     

 

Mailing Address__________________________________________________________

                                     Street                                                            Apt. # 

 _______________________________________________________________________

            City                                       State/Province                     Zip/Postal Code

 

Telephone __________________________________________

 

E-mail Address_______________________________________