SKCHE MEMBERSHIP REGISTRATION FORM
2006-2007 Membership Dues - $15.00
(After January 1, 2007 - $7.50)
Click here to return to the SKCHE Website - www.geocities.com/skche.group
PRINT CLEARLY
Date: _______________________
Last Name: ________________________________________________
First Name(s): ______________________________________________
Phone: _________________________
Address: __________________________________________________
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Email Address: _____________________________________________
Children's Names �������������������������������������������������� Birth Year
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Make check or money order payable to:
Denise Furey
Mail Membership form & payment to:
Rhonda Langley
11305 Kensington Ave.
Kansas City MO 64137		 For Office Use Only:
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