MSU Blue Line Club

2007-2008 Membership Application/Renewal

Name ______________________________________________________________________

Address ____________________________________________________________________

City ____________________________________ State/Province _______________________

Zip/Postal Code __________________ E-mail address _______________________________

Renewal ____ New Membership ____

STUDENT - Elementary, secondary, or post-secondary $ 6.00 __________
SINGLE - Individual person $25.00 __________
FAMILY - Married couple or one adult, plus children under 18 $30.00 __________

Name of Family members:___________________________________________________
___________________________________________________
___________________________________________________

Show your Pride in your MSU Blue Line Club by Ordering a Permanent Club Name Badge

(badge is 3.5" x 1.25")

Names to be Engraved on Badge (First and Last)
___________________________________
___________________________________
___________________________________ # of Badges _____ @ $10.00 each = $________
___________________________________

Pins from previous years: years requested _____________ @ $3.00 each $________
Stickers from previous years: years requested _____________ @ $3.00 each $________

Total Dues $________

Amount Enclosed $________
Make checks payable to:
MSU Blue Line Club, P.O. Box 804, East Lansing, MI 48826-0804