Southern  California

Garden  Railway  Society

 

 

 

NEW  MEMBERSHIP  APPLICATION

 

PLEASE PRINT ALL INFORMATION

 

 

FIRST NAME:                                       LAST NAME:                             

(NOTE:  THIS IS THE WAY YOUR NAME WILL APPEAR ON BADGE # 1.)

SPOUSE’S NAME:                                                                                         

(NOTE:  THIS IS THE WAY YOUR NAME WILL APPEAR ON BADGE # 2.)

 

ADDRESS:                                                                                                                                                                                                                       

CITY/STATE/ZIP:                                                                                          

 

HOME PHONE:                           FAX:                      E-MAIL:                          

 

Do you have a layout?           YES       NO        Under Construction

 

IF YES,                   INDOOR            OUTDOOR 

 

Are you interested in a clinic on electrical, model building, train layout design or another subject?         

YES            NO        If yes, indicate your interest:                                         

 

Would you be willing to host an open house?          YES           NO   

 

NAMES TO APPEAR ON ADDITIONAL BADGE(S)  INCLUDED IN FAMILY MEMBERSHIP

 

BADGE #3: FIRST NAME:                      LAST NAME:                   

 

BADGE #4: FIRST NAME:                      LAST NAME:                   

 

 

NAMES TO APPEAR ON ADDITIONAL BADGE(S), $3.00 EACH, SAME FAMILY

 

FIRST NAME:                                                LAST NAME:                   

 

FIRST NAME:                                                LAST NAME:                   

 

 

AMOUNT ENCLOSED:                 $40.00 New Membership                             

                                               

                                                Badges $3.00 x (Number of Badges)             

 

                                                TOTAL AMOUNT                                         

 

                                                MAKE CHECK PAYABLE TO SoCalGRS

                                                MAIL TO: RON DEISLER,

                                                4532 GRAYWOOD AVE, LONG BEACH CA  90808-1015

OFFICIAL USE ONLY:

 

Date Received:

                            

 

Check #