Membership Application


To become a member, please complete this application. You MUST fill in all the fields in red and enter the characters you see at the end of the form in the box, otherwise your application will not be processed.

Membership dues are $30.00 per person, which are due in January.


New Membership

Membership Renewal

Name (First Name, Last Name)

Spouse's Name

Address1

Address2

City

State

Zip

Home Phone

E-mail


If you don't live here full time, please list the times you are away as well as your other address.

Away From
until
Address1
Address2
City
State
Zip

Our club is always looking for volunteers - please select an area or areas of interest in which you may like to participate.

Dances
Picnics
Newsletter
Committee Chairperson
Officer
Director
Baking

Do you have any special interests or hobbies you would be willing to share with us at a membership meeting?



Please enter the characters you see in the image in the box below

(refresh page for new image)

Image verification