Member Information Provide Updates/Changes Only

2017 PAYMENT FORM FOR RETURNING MEMBERS Member Information – Provide updates/changes only NAME Member Number

Member Information Changes. Provide any updates to address, phone, email or members

Last Name First Name Relation Birthdate Health Concerns

2017 Dues Rate 1 member $320, 2 members $370, 3 members $420, 4-7 members $470. $ Add $40 (to $470) per additional dependent for families of 8 members and more.

Senior (62+) rates: 2 seniors $320 1 senior $270 Outstanding Obligations $ Less Discounts Early Payment -$15 (before March 15th) Less $ Tiger Alum (18+ individual who swam on the team) -$100 Late fee after May 15th, 2017 $50 $ Total $

Payment Instructions. Dues are to be paid in full by May 15th, 2017 (by-laws regulation). Installment plan is limited to no more than four (4) installment payments. If you opt to pay by installment plan, divide TOTAL DUE by number of payments desired. Send first payment with Payment # 1 and keep remaining installment slips for future payments. Up to four post-dated checks may also be sent. Make checks payable to Wheaton Woods Swimming Pool. Mail to Wheaton Woods Pool, P.O. Box 295, Rockville, MD 20853.

Method of Payment (Circle one) Check Paypal Money order Installment Plan WWP Installment Payment Member Name: ______Amount Enclosed: $______#4 of $______Checks payable to Wheaton Woods Swimming Pool. DUE NO LATER THAN MAY 30, 2017 Mail to Wheaton Woods Pool, P.O. Box 295, Rockville, MD 20853 Member Name: ______Amount Enclosed: $______WWP Installment Payment #3 of $______Checks payable to Wheaton Woods Swimming Pool. Mail to Wheaton Woods Pool, P.O. Box 295, Rockville, MD 20853 Member Name: ______Amount Enclosed: $______

Wheaton Woods Pool 4610 Landgreen Street

P.O. Box 295 Email:[email protected] Rockville, MD 20853 www.wheatonwoodspool.com WWP Installment Payment #2 of $______Checks payable to Wheaton Woods Swimming Pool. Mail to Wheaton Woods Pool, P.O. Box 295, Rockville, MD 20853 Member Name: ______Amount Enclosed: $______WWP Installment Payment #1 of $______Checks payable to Wheaton Woods Swimming Pool. DUE NO LATER THAN MAY 15, 2017 Mail to Wheaton Woods Pool, P.O. Box 295, Rockville, MD 20853

Wheaton Woods Pool 4610 Landgreen Street

P.O. Box 295 Email:[email protected] Rockville, MD 20853 www.wheatonwoodspool.com