B.R.G.S.MEMBERSHIP
APPLICATION FORM

NAME:______________________________________________


ADDRESS:___________________________________________

          ___________________________________________

          ___________________________________________

I wish to apply for membership of the B.R.G.S. Inc.

Enclosed is full payment consisting of an initial joining fee of $5.00

and yearly membership fee of

$20.00 Single Membership

or

$25.00 for a Family Membership


Total enclosed being $_______________



Please make cheques or payments to B.R.G.S. Inc. and we look forward to having you as a member.


Signed: ___________________     Date: ______________