Membership Application

Copy, paste, then print to fill out

The Brennan Society Honoring William J. Brennan, Jr.
Former United States Supreme Court Justice
Membership Application


(Please Print)
Preferred Name______________________________________________________________


Mailing Address______________________________________________________________


(City, State, Zip Code)________________________________________________________


E-mail Address (Note Case Sensitive Letters)__________________________________________


Home Telephone Number (________)____________________________________________


Cell Telephone Number (________)______________________________________________


The Single Most Important Public Issue to Me Is:

__________________________________________________________________________


__________________________________________________________________________


circle one:


Enclosed is My Check for $20 for My Current Year’s Membership*
OR
Enclosed is My Check for $200 for My Lifetime Membership


Please Mail to: Brennan Society, 2109 Rushing Meadows, Edmond, OK 73013


Please Make Your Check Payable to: The Brennan Society


* This Annual Membership Expires January of the Next Calendar Year.
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