Please GIVE TO YOUR CLUB TREASURER to COMPLETE and RETURN by
July 1, 2009.  PLEASE RETURN THIS FORM EVEN IF NO CHANGE.

South Carolina Federation of Republican Women
CLUB    MEMBERSHIP   REPORT

Date of this report: ________________

Notice of dues payable as of: _____________________________

Service Charge of $30.00 payable ONCE A YEAR                  $________

Dues of $13.00 per member.  ____ member(s) x $13.00           $________

NAME OF CLUB: ___________________________________________

CLUB’S CHARTER DATE: ________________

CLUB’S FEDERAL EIN#: _________________

Number of paid members this report: ________

Number of total paid members 2009: ________

Club President: ________________________________________________

Club Vice President: ____________________________________________

Club Secretary: ________________________________________________

Club Treasurer: ________________________________________________

(see instructions on back page)

Instructions:

Report the names and data for associate members (please attach separate list from members list).

Please include the following information for each member you are reporting: name, mailing address, 9 digit zip code, telephone numbers, fax number, e-mail address, and congressional district.

Include only paid members and paid associate members (we are reporting associate members).  No money is due for associate members.

Please note that membership in SCFRW and NFRW runs from January through December of each year.  All checks must be made payable to SCFRW and written on a club checking account (no personal accounts).

Please keep a copy of this report for your records and return one copy to me along with your club check and data on the members reported on this form.

Thank you,
Lisa Manini Sox
SCFRW Treasurer
E-mail: lmsox@sc.rr.com
Please mail reports to:
Lisa Manini Sox
Treasurer, SCFRW
812 Oak Burne Court
Lexington, South Carolina 29073