Update RSC Member's
Contact Information Form
E-mail Address(es):
Telephone Contact Information:
(Format: (xxx) xxx-xxxx)
RSC E-mail Message preference:
(Check one box below)
Effective Date:
Member Name:
Street Address:
City:
State:
Zip Code:
PO Box Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Work Phone:
Home:
Work:
Past Club Offices Held & Recognition Awards Received from the Richmond Shag Club: 
(Please complete, if appropriate)
RSC Automated Phone Messages:
(Check one box below)
For Club Auto-Calls
For Club Auto-Calls
For Club Messages
For Club Messages
No Club e-mails please!
For Club Auto-Calls
No Club Auto-calls please!