The following items are essential for club records and mailing

newsletters:

Name:_________________________

Address__________________________________

City:____________________ State:_______ Zip__________

These items are optional and are to be filled in if you have

no objection:

Home Phone:____________

WorkPhone:_____________

E-mail:___________________

Occupation:____________________

Employer:___________________________

Previous Brewclub Membership:______________________

Years Brewing:_________

I would like to help SNAFU by working as/at:___________________________________

Send this membership application to :

SNAFU Membership

3508 Bogside Way

Las Vegas, NV 89129

You may also leave this membership application at Mr. Radz Homebrew Supply or bring it to a SNAFU club meeting.