PennADE 2010
  Meeting Dates
Mark Your Calendars NOW!

Feb. 18, 2010  (Th)  12 - 4 pm

May 12, 2010 (W)  9 am – 1 pm

Sept. 15, 2010 (W)  12 - 4 pm

Dec. 1, 2010 (W) 12 - 4 pm

PennADE Membership Form
2009-2010

 Please fill out the form completely.  The 2009-2010 membership directory will be compiled from this information.
 Please print legibly.

Name _________________________________________________

Title ____________________AADE #_________________

Home Address ________________________ City________________ State _____ZIP_______

Home Telephone number:  (____) ___________________

Work Place (Institution/Company/etc.) ________________________________________________

Work Address ____________________________ City ____________ State _____ Zip _________

Work Telephone number:  (____) ___________________ Fax #:  (____) _____________________  

Email address:  ________________________________

Preferred mailing address (both addresses and telephone numbers will be listed in the membership directory)      
 Home ___________ /   Work ____________ 

Mail this form and $30.00 due to the following address by September 30, 2009. After September 30 the amount is $35.00 (renewals only).  If retired, the membership dues are $10.00.   Please make check payable to PennADE. If your membership dues are not returned by September 30 your information will not be included in the membership book.
                                                                                                      For Treasurer to Complete
                                                         Carol Spicher                             Check #_____________
                                                             PennADE                              Date received____________
457 West Main Street
Mountville, PA 17554-1918

IF YOU HAVE NOT YET VOLUNTEERED TO SERVE ON A COMMITTEE AND WOULD LIKE TO VOLUNTEER, PLEASE CHECK FROM THE FOLLOWING THE COMMITTEE OF YOUR CHOICE: