2011-2012Membership Dues and Contributions Form

Member Name / Email Address
(please print on line below)
Address
City/State/9-Digit Zip Code /
Check here if your contact information has changed.
Phone / ( )

Part I. Dues Section

Dues / Amount / Amount
*Member’s Dues 2011-2012 (Includes National, State and Chapter) *Required / $ xx.xx* for chapter members ($x.xxfor associate members) / $
DAR Magazine (1-yr subscription) / $ 18.00 Circle: New or Renewal / $
State Newsletter (1-yr subscription) / $ x.xx Circle: New or Renewal / $
Mailed Minutes (1-yr (Sept-June) / $ x.xx / $
Postage / $.45(please add .45 if you want your directory mailed) / $
$ xx.xx for Standard Chapter Dues Membership Package (inc. Dues, DAR Magazine, DAR Newsletter and State newsletter) / Membership Dues SubTotal / $

Part II. Contributions Section (optional)

Contributions
(see list below) / Name of Fund (use additional sheets of paper if needed) / (Name of Person)
In Honor (H) or In Memory Of (M): / Choose H or M / Amount
Chapter Donation / $
Chapter Donation / $
Chapter Donation / $
State Donation / $
State Donation / $
State Donation / $
National Donation / $
National Donation / $
National Donation / $
Part II Contribution Subtotal / $
Part I Membership Dues / $
Grand Total / $ /

Make your check payable to xxxx Chapter. Pay before xxxxx.

Send this remittance form with your check to: Name, Chapter Treasurer, Address, City, State, Zip

List of Contributions

Chapter Funds / State Funds / National Funds
(customize for your chapter) / (customize for your state) / CAA National Donations / Volunteer Contributions/Donations
  • Chapter Chaplain's Sunshine Fund
  • Chapter DAR Magazine contributions for local Schools, Libraries
  • Chapter General Fund
  • Chapter Good Citizen's Awards
  • Chapter Membership Teas
  • Chapter Program/Speaker Funds
  • Chapter Veteran's Party
  • Mount Rosa Scholarship Fund
/
  • Adult Advanced Education Scholarship
  • C.A.R
  • General Operating Fund
  • Junior Project’s Fund
  • Outstanding Junior Fund
  • Service to Veteran-Patients
  • State Regents American History Scholarship
  • JAC Prize Award Fund
  • State Regent’s Project
/ *Historic Programs and Funds
*Educational Programs and Funds
*Patriotic Programs and Funds
*Membership Programs and Administrative Funds /
  1. DAR Museum Exhibition Fund $200
  2. DAR Project Patriot $100
  3. Friends of American History $100
  4. Friends of Genealogy $100
  5. Friends of Junior American Citizens $100
  6. F. Friends of Junior Membership $100
  7. Friends of the Americana Collection $100
•Button Gwinnett $200
  1. Friends of the American Indian
  2. Friends of the DAR Magazine $100
• Friends of American Spirit$100 (plus 5 new gift subscriptions sent w/ donation) / J. Friends of the Museum $200
•Adopt-An-Object $100
• Museum Keeper $500
  1. Friends of DAR Scholarship $200
  2. Friends of DAR Schools $200
  3. Friends of the Library $200
  4. Friends of Seimes Technology Center $100
  5. Friends of Veterans $100
  6. Membership Challenge $500
  7. NSDAR Archives Fund $100
  8. President General’s Project $100

Note: All donations given that are not specified to a fund will go directly to the Chapter's General Fund. If you are interested in making a Friends contribution, lease contact the Chapter Regent or Chapter Treasurer.

*Chapter Requirement as part of the Chapter Achievement program. For more info about this program, contact the Chapter Treasurer

QUESTIONNAIRE FOR CHAPTER MEMBERS

This questionnaire has been designed to serve as
a tool to sense member opinions and help chart future actions for our chapter.

  1. When is the best time for you to attend DAR monthly meetings:
Monday Afternoons_____ Sunday afternoons______Friday evenings______Saturday morning ______Other suggestions______

2.Would you like meetings to include program and:

Refreshments ____ Luncheon/Supper ______Pot Luck_____ Meeting only____

Would you be willing to pay every month to cover meal costs? Yes___ No____

Would you like a combination of meetings throughout the year with luncheons, potlucks, etc.? ____Yes ____No Please describe. ______

3. I am willing to pick-up other DAR members for monthly meetings______

4. I would like a car-pool ride to monthly meetings______

5.I can participate on DAR activities: (check all that apply)

Weekdays only_____ Weekends only_____ Evenings only______

Sept/Oct_____ Nov/Dec_____ Jan/Feb_____ Mar/Apr_____ Jun-Aug____

Fall _____ Winter _____ Spring _____ Summer _____

Most months of the year_____ Other_____

  1. I would be interested in volunteering: (check all that apply)

for activities that I can do at home
for activities with the C.A.R.
as an officer
as a committee chairman
as a committee member
on fundraisers
on patriotic activities
on educational activities, such as reading, tutoring, literacy
on genealogy & lineage research
on program and special workshops
on public relations, such as writing newspaper articles about chapter activities / on historic preservation
on membership, such as helping members become oriented
to make/draw posters and flyers for chapter activities for Constitution Week and American History month
on scrapbooking to help with Historian duties
to mentor prospective and/or new members"
 to assist with "adopt a member" (to occasionally visit, send cards, etc. to elderly members who can no longer attend meetings

7.1 work or volunteer: Full-time_____ Part-time_____

I am retired_____ I am at home full-time_____

I have children in school_____ Pre-school_____

I am between 18 and 35 years old_____ (Junior member) I am between 36-50 ______

I am between 51-70______I am 70-89 ______I am 90 years old or over______

8. Please include any additional comments:

Thank you!!!!! Please return this along with your dues to the chapter treasurer.