Please return completed Dues Statement (download the pdf) along with your check for the amount
owing made payable to“WRJ Pacific District” by January 15, 2011 and mail it to:

Marjorie Meadow, WRJ District Treasurer
6652 Lennox
Van Nuys, CA 91405

We suggest you make a copy of this completed statement to retain for your records.

Thank you,
Marjorie Meadow

WRJ PACIFIC DISTRICT ________________________________________________
NAME OF SISTERHOOD  _______________________________________________
CITY  ________________________________________________________________

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

CALCULATION OF DUES:
NUMBER OF MEMBERS_ __ __ _ __ __ X $2.00 = $_____________ (AMOUNT OWING)
($1.90 for Pacific District plus $ .10 for support of our two camps)