COWBOY APPLICATION FOR MEMBERSHIP

Date of Application: ___________________

______ New Member Fees: _____ $35/year - Individual

______ Renewal _____ $60/year - Family (all members living in same household)

______ Reinstatement

Send your completed form, along with your check made payable to The Cowboys to the following address:

THE COWBOYS

3843 So. Bristol Street,

PMB #: 284

Santa Ana, CA 92704

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THE COWBOYS USE ONLY:

Membership Card (circle one): Mailed Issued

Mailed/Issued by: ______________________

Paid by (circle one): Cash Check # __________

Amt Paid: ___________________

Renewal Date: ____________________

Data Entry: ____________________________________ Date Entered: _______________________________