Valley Stream Running Club

Please print out this page, complete the application
and mail with dues to the address listed below.

Membership Application

Name:__________________________________________

Address:________________________________________

            ________________________________________

Home Phone:_________________

E-mail:______________________

Signature:____________________ Date:______________

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Special Rate of only $15.00 for 2008

Fee Submitted  $__________     Check#_______________

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For further information contact the Club's President,
Stanley Friedlander        Phone: 516-791-6513
E-mail: stanfdl@optonline.net
Web site: www.VSRunningClub.org

Mail Application & Dues to:

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