MEMBERSHIP APPLICATION 
2003-2004

Section ________

Membership fee $20 

Name: _______________________________________________

Address: _____________________________________________

City: _______________ State: _______ Zip: ___________

Home phone: (_____)_______________________    Daytime phone (____)_______________________

E Mail Address _________________________________________________

* Note: Please put the name of your school on the lines below! 
If you are the head coach for the boys and girls, place a check in appropriate space.

SCHOOL NAME (BOYS): _____________________________________

School Address: _____________________________________________

City: _______________ State: ______ _ Zip: ___________

____ Head Coach _______ Asst. Coach

SCHOOL NAME (GIRLS): _____________________________________

( Please fill out address if you are at a different school)

School Address: _____________________________________________

City: _______________ State: ______ Zip: _____________

____ Head Coach _______ Asst. Coach

PLEASE SEND ALL MEMBERSHIP APPLICATION AND DUES TO:

Membership fee $20 

Joe moreau
2360 95th Street    
Naperville , Illinois 60564

Date payment rec.: ________

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