Membership Form
Become a new member using the form above.
Fill out the form and Save to your computer. It can then be printed and mailed to the address provided on the form or attached to an email to the
Bannock Civitan Secretary Connie Doerr - connie@bplan.org
You can also manage your membership with this form. Changes and Deletions.
Officers and Board Members:
President - Claudia Allen
Past President - Marcus Sierra
President Elect - Connie Doerr
Treasurer - Michelle Ellis
Secretary - Sherry Rindels Larsen
Board Members
Frances Ashcroft
Charlie Dickson
Terry Fredrickson
Pam Holmes
Ann McCarty
Tiffany Olsen
Neil Tocher
Teresa Wakeman

Pictured:
Board members Frances Ashcroft, Gerald Kimber, Charlie Dickson, Teresa Wakeman, Ann McCarty, Neil Tocher and Tiffany Olsen
Treasurer - Michelle Ellis, Past President - Marcus Sierra, Secretary - Sherry Rindels Larsen
President - Claudia Allen, President Elect - Connie Doerr
Not pictured: Terry Fredrickson and Pam Holmes