SCCHE MEMBERSHIP REGISTRATION

 
[  ] I already emailed my information To Barb or Margaret and only need to fill out the **starred family information.

**Date: ________________  

**Name: ___________________________________________________

**Spouse’s Name: ___________________________________________

Address: _________________________________________________

City: ________________________State: _______Zip: ____________

**Phone: ___________________________________________________

**Email: ___________________________________________________ (please check this for legibility)

Children’s names and birth dates (month/year):                                                                                

Name of home church (Optional): ______________________________________________________

Curriculum Used (Optional): ___________________________________________________________

___________________________________________________________________________________

**Membership Options:

[   ]    I would like to be a member of SCCHE.  Enclosed is a check for $15.00.  I understand that with this $15.00, I will be a member in good standing of SCCHE from June 2007 through May 2008.  This membership covers me for participation in SCCHE activities and functions.  I will also receive a membership card, access to "members only" areas of our website, and a Buzz Book.

[    ]    I would like to have my Buzz Book mailed to me. I understand that there is an extra $3.00 charge that I will add to my membership fee below to cover postage and handling.

**Total Enclosed: __________ Check Number: ____________  [  ] Check here if payment was made in Cash.

Please mark one:

[    ]    I am a new member.

[    ]    I am a renewing my membership.

[    ]    I am reinstating my membership.  (I was a member in the past, but not during the 2006-2007 school year.)

Please mail this form to the address listed below.  Please make your check payable to “SCCHE” for the appropriate amount.  Thank you.

SCCHE Membership

c/o  Debbie Winfield

278 Brook Lane

O’Fallon, MO 63368