Come join the fun of dancing. Please read the content on the MEMBERSHIP page to figure the amount of your dues. Print and fill out this Membership Application and mail it with your dues (full-time students thru college are free) to: THMDC, 15749 Mata Rd., Plantersville, Tx 77363. For info: 936/894-2804 or email luvtopolka@aol.com.
Mbr# _____ Renewal ___ Data Change ___ Chk# _____ Date _______
TEXAS HERITAGE MUSIC & DANCE CLUB
MEMBERSHIP APPLICATION
___ 1 to 4yrs @ $12/pp/yr* ___ 5yrs $55/pp ___ 10yrs $100/pp
*If joining between January and June, please pay $1 per month of the remaining year (ending June 30) PLUS $12 for the following year’s dues. Thank you!
Name______________________________________________________
Address: ____________________________________________________
City/St: _______________________________ Zip: ____________
Home Phone: ____________________ Cell: ___________________
Email: ________________________ Referred by: ______________
Comments: _________________________________________________
If Student: Age ___ Grade ___ School__________________________
If in College, include latest transcript.
Parents and grandparents, your school children and grandchildren are welcome to join for FREE, so they can learn to dance. Make this a FAMILY AFFAIR. Your children will enjoy dancing the rest of their lives. You may submit a separate application for each school child so they will be issued a separate Membership number. Each month, new members will be welcomed by posting their names on this site.