Membership Application
For our records, we need to know your name, address and telephone number. Your email address is optional, but we do hope to make better use of modern methods of communication in the future.

Company/Club:
Salutation:	Mr Mr & Mrs Ms Attn:
First Name:
Last Name:
Spouse's Name:
Mailing Address:
City, State Zip:	,
Home Telephone:
email:

Instructions:

• Please fill out and print.
• Make your check for $30 (single membership) or $50 (family membership)
  payable to Swiss Benevolent Society.
• Mail the check and the completed Membership Form to:
  
  Swiss Benevolent Society
  456 Montgomery St., #1500
  San Francisco, CA 94104-1233