Membership Form MEMBERS GENERAL DETAILS: First Name Middle Name Last Name DOB (mm/dd): Blood Group: Male/Female Select One Male Female Address City/State/Zip: Phone Email T- Shirt Size: Small Large X-Large Your Interest or preferred role(s) in the organization (please ): Singing/Volunteer Work/Blood Donation/Sports/Women Empowerment/ Youth Development/Bringing New Ideas/Not Certain/Others (please specify): Emergency Contact: First Name Last Name Relation Address Zip Membership Benefit Newsletters Meeting Updates Annual Family Dinner/ BASCO Annual GALA Upcoming Event Information’s Discounts on BASCO events More Benefits- TBD Pay Later Pay Now