MEMBERSHIP RENEWAL APPLICATION

Name: ________________________________________________________________

(Please print) Last First MI

Address: ________________________________________________________________

Street City State Zip code

email_________________________________

Home phone: ___________________________

Work phone: ___________________________

Cell phone: ____________________________

Birthdate: _______________

U.S. Rowing membership number: ____________ ____________________

Annual dues:

Members.......$450/year

Summer Competitive Members $525

Summer Novice Program Members $525

Signature Date