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Club Payment Form

Club:
Payment for*:
Newcomer Section? Yes No

Actuals for previous month:

Week 1 Week 2 Week 3 Week 4 Week 5
Tables
Free Plays:
Fill-in
Certificates

Other Rent: $ for:

Late Fee: Check if payment not provided to the Unit Treasurer by the 7th of the month.

Comments:

*Month payment is due, not the previous month it is based upon.

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This page last updated on Sunday, June 5, 2011