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JOHNNY DEROSE FAN CLUB APPLICATION 

JOHNNY DEROSE FAN CLUB
TRIBUTE TO ELVIS
 
APPLICATION FOR MEMBERSHIP
Name:______________________________________________
 
Address_____________________________________________
 
Phone:__________________________________
 
Age:______________(Optional)Birthday:____________________
 
Send Check or Money Order to:  
  Shirley Schwebs
  2620 Virginia Drive
  Kissimmee, FL  34741
  Phone: (407)847-3012
 
DUES: $10.00 per year.
 
Club Membership entitles you to:  Quarterly Newsletters, Membership Card, Special Bulletins, Special Social Functions, 8x10 color photo, Special item for renewal.
 
 
What things would you like to see in the newsletter:_____________________________________________________
 
How did you hear about Johnny and where have you seen him perform?_____________________________________________________________________
 
We thank you for your interest in Johnny and we hope to make your association with this club a rewarding experience. We welcome your comments and suggestions.
 
President: Shirley Schwebs - djklv@earthlink.net
Vice-President: Diane Barrett
Secretary: Brenda Deems
Coordinator: Alberta Hiller
Treasurer: Brenda Deems
Publicity: Linda Hiller
 
Website and various merchandise: Judy Taylor - kountrie72@embarqmail.com
 
 
 

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