MASDA MEMBERSHIP/CHANGE OF ADDRESS 

NOTE: Use this form for membership renewal or change of address

MASDA membership is $30 per year for singles or couples. Your membership includes up to four dances with Atlanta Area Callers and Cuers, two dances with National callers and 12 issues of FOOTNOTES. To insure uninterrupted delivery of FOOTNOTES, please renew by the 12th of the month to receive next month's issue. The expiration date is shown in the top line of your mailing label.

[  ] NEW MEMBERSHIP       [  ] RENEWAL        [  ] CHANGE OF ADDRESS          CHECK#_________ 

PLEASE PRINT

MEMBER(S)____________________________________________________________________________________
                                           LAST NAME                                                         FIRST NAME(S)

PRESENT ADDRESS_____________________________________________________________________________
                                    STREET                                                              CITY, ST                                             ZIP CODE

OLD ADDRESS__________________________________________________________________________________
                                    STREET                                                             CITY, ST                                               ZIP CODE

PHONE__________________________ E- MAIL_______________________________________________________


ACTIVE MEMBER OF CLUB(S)____________________________________________________________________
                                                                  

Make checks payable to MASDA and mail to:


Mike & Marcia Massey
1606 Brentwood Drive  
Marietta, GA 30062-2042

 

Updated: 19JAN14/Sun - MeM