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Membership Form 2006 - 2007Please print this form and include it with your check ($150) made payable to UMCP Foundation. Mail to: Jim Routh c/o Gary's Fastbreakers 1929 Lewis Avenue Rockville, Maryland 20851 terpmail@comcast.net First year $100 The Fastbreakers' charter requires that all members belong to the Terrapin Club. Annual membership dues are $150.00 (of which $80.00 is a tax deductible contribution to the Fastbreakers Scholarship Fund. Annual membership earns 4 Terpoints per every $100.00 donated. _____check for $150.00 payable to: UMCP FOUNDATION _____credit card circle one: VISA / Master Card / American Express / Discover Card Number: ___________________________________________ Expiration Date:_________ Full Name on Card: __________________________________ Signature: __________________________________________ |
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This page is maintained by J. Nodine |
Last Modified
March 6, 2007 |
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