Remittance Form – Summer 2018

REMITTANCE SLIP – WCSC Maintenance Fee Payment 2018
(Save paper! Remittance slip not needed with check payment if name on check matches the name on the membership!)

 

Name: _______________________________________________________________

Member No.: _____________

Amount Enclosed: __________________

Payment method:
Check  ______ Check #: _______  (Make check payable to: Waugh Chapel Swim Club)
Credit Card:  ___ Visa   ___ M/C  ___ Discover  [$10 processing fee will be charged]

Credit Card Number:  ____________________________________________________

Expiration Date:  ____________________________

Name on card: _________________________________________________________

Signature: _____________________________________________________________

________________________________________________________________________

Mail payment to: WCSC, P.O. Box 212, Gambrills, MD 21054 – Attn: Membership Renewal