APPLICATION FOR DIRECTORS & OFFICERS
LIABILITY INSURANCE
FEB. 15, 2008
through FEB. 15, 2009
GSBF CLUB NAME ______________________________________
PHONE_______________________________
REPRESENTATIVES NAME _________________________________
TITLE _____________________________
ADDRESS
______________________________________________________
CITY ___________________________ STATE _________ ZIP
___________
MEETING LOCATION:
ADDRESS______________________________________________________
CITY ____________________________ STATE _________ ZIP
___________
How often your club meets ?
________________________________
How many members your club has? __________________________
Make Checks payable to:
GSBF INSURANCE FUND
Mail to:
Abe Far
2451 Galahad Road
San Diego, CA 92123
For questions, phone (619) 234-3434 or
E-Mail
AbeFar@cox.net
Postmark deadline for submission of your 2006
application is February 12, 2006.
Fee of $25 applies to each late application (except new
members).
