Membership Form

Annual dues are $30.00
Make checks payable to: Clipped Bs
Please fill out form and print. Mail your check along with your Membership Form to:
 
Address:   Clipped Bs Membership Chairman
               6255 West Northwest Highway  #204
                 Dallas, Tx 75225


YES! I accept your invitation to become a member of the Clipped B's.
Renewal
New Member

If you were a member last year, has your information changed?
No Change
Change

Here are my annual dues in the amount of $30.00 Mailing Dues with a copy of this form


Listing in the year book (Select One) Mr Ms Miss Mrs

Full Name:

Address:

City, State, Zip Code:

Home phone:

Cell Phone:

Alternate Phone:

Email Address

Buzz Notes by Email only or US Mail? Email US Mail

Name as Braniff Flight Attendant:

Years as Braniff Flight Attendant from 19____:

Years as Braniff Flight Attendant until 19_____:

Birthday:

Select Chapter Affiliation: Dal Hou Sat Den Lax Msp Mkc



**Please Read

After form is printed verify all information.

Make sure the selected boxes & radio buttons are clearly marked

(if needed use a pen to darken your selections)
Mail this printed page along with your dues to the address above.
Thank You