Join Us

New Member Application

Membership dues through June 30, 2014:

  • $60 Annual Membership
  • $100 for couples
  • $85 Gold Membership
  • $125 Platinum Membership

Pay by sending either:
* Credit card info – type (Visa, MC, Amex), card number, expiration date, and signature
* Check made out to “Brandeis University”
And mail it to:

Betty Jane Koppel
7531 East Calle Brisas
Tucson, AZ 85750

Questions? Contact Betty Koppel at BettyKoppel@aol.com or 296-1215.

This check should not be combined with any fees for any other function or for Study Group sign-up.

Please fill in the form below:







Member 1Member 2

First Name (required)

Last Name (required)

Phone Number (required)

Cell Phone Number

Email

Non-member spouse name


First Name

Last Name

Phone Number

Cell Phone Number

Email

Main AddressOther Address

Street (required)

City (required)

State (required)

Zip Code (required)


Street

City

State

Zip Code

Other Phone Number

Dates at Other Address


Sponsor

Membership type:

Comments:

Prove you're not a robot:


Pay by sending either:
* Credit card info – type (Visa, MC, Amex), card number, expiration date, and signature
* Check made out to “BNC”
And mail it to:

Betty Jane Koppel
7531 East Calle Brisas
Tucson, AZ 85750

Questions? Contact Betty Koppel at BettyKoppel@aol.com or 296-1215.

This check should not be combined with any fees for any other function or for Study Group sign-up.