Central Texas Deaf Senior Citizens – Application Form
To: Readers of Deaf Network of Texas
Central Texas Deaf Senior Citizens, a non-profit organization, established
on July 27, 2011. CTDSC not only serves the Temple/Waco regional area, but
is also for past, present, and future Texans, and Texans’ friends.
Welcome to Central Texas Deaf Senior Citizens (CTDSC)!
The CTDSC’s January 2012 Newsletter will be ready to send out to CTDSC
members very soon.
Have you been waiting for the first issue of the CTDSC’s Newsletter? Did you
want to subscribe to the CTDSC newsletter? NOW is the best time to sign up
to receive our first issue.
Here is the CTDSC application form.
Central Texas Deaf Senior Citizens
Name: __________________________________________
Deaf/HH or Hearing (please pick one)
Address: ___________________________________________________________
City: _________________ State: _______ Zip: ________County: _______________
VP# (_____) _________________
Birthdate _____________________
Check one of the following:
MEMBERSHIP & NEWSLETTER (60 years old and up) – $10.00 each year
New or Renewal (please pick one)
OR
NON-MEMBER NEWSLETTER SUBSCRIPTION ONLY (59 YEARS OLD AND BELOW) – $10.00
EACH YEAR
New or Renewal (please pick one)
Enclosed is $ _______
*Gift Membership (from who___________________________________________
*Donation $ ________ to CTDSC in memory of _____________________________
*Donation $ ________ to Central Texas Deaf Senior Citizens
Mail the above form with a check or money order (payable to “Central Texas
Deaf Senior Citizens”)
Email: _______________________________
Birthplace ____________________________
to CTDSC, c/o Rennon Green, Treasurer, 125 McGugan Lane, Temple, TX 76502-
3527.
Thank you for your support.
Download Central Texas Deaf Senior Citizens Application Form (PDF format)