Batik Club
Batik Club Membership Registration Name: Street Address: City, State Zip: Phone #: Email Address:
6-month membership $120 12-month membership $240 $230
Start Month: ____________________
Date Paid: ______________ Amount Paid: ________________ _____________________________________________________ Voucher Month 1 2 3 4 5 6
7 8 9 10 11 12
Date Used
Employee Initials
6-month membership $120 12-month membership $240 $230
Start Month: ____________________
Date Paid: ______________ Amount Paid: ________________ _____________________________________________________ Voucher Month 1 2 3 4 5 6
7 8 9 10 11 12
Date Used
Employee Initials
