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The Shepherd’s Center of Annandale–Springfield P.O. Box 1827, Springfield, Virginia 22151 (703) 941-1419
Anyone fifty years or older is URGED to Join (anyone of ANY age is WELCOME to join!)
Membership Application (Please print this form, fill it out, attach payment and mail to the above address)
______________________________________________________________________ Last Name First Middle Initial Telephone
______________________________________________________________________ Address City State Zip
____________________________ E-mail Address
Name of my Congregation (if applicable) _St. Alban’s Episcopal Church_________
2007/2008 Membership Year
ENCLOSED IS: (Check can be made payable to “SCAS”)
Annual Membership Dues: $5.00
______________________________________________________________________
In order to assist older persons to continue to live independent, meaningful lives, the Shepherd’s Center of Annandale–Springfield is eager to recruit additional volunteers. If you are interested in becoming a volunteer, please check your area(s) of interest (Current volunteers need not complete):
Office manager ___________ Office staff 1 day a week ______________
Publicity director __________ Volunteer recruiter ___________
Faith community liaison ____________ (work with your own church or religious center)
Adventures in Learning coordinator or assistant ______________
Website designer __________ Webmaster_________________
Internet researcher ___________ Communicate with other seniors’ agencies_____
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