2007 Individual Membership

     Trego County-Lemke Memorial Hospital Auxiliary would like to invite you to join the ranks of hospital supporters by purchasing an Individual Membership to our local chapter.              

Thank you for your support.

Please complete the form, print and mail along with your donation payable to:

TCLMH Auxiliary Membership

c/o Reba Bayuk

509 N. 9th Street

WaKeeney, Ks.   67672

Name:

Address:

Phone:

MEMBERSHIP STATUS:

DO YOU WISH TO BE ACTIVE OR INACTIVE?

Please check as many items as you would be willing to help with.

*** Please be patient with us in the scheduling of working hours.