SPEAK EASY SINGLES - MEMBERSHIP  APPLICATION - 2008

WELCOME!  WE ARE PLEASED THAT YOU ARE INTERESTED IN JOINING OUR GROUP AND HOPE YOU WILL ENJOY OUR  ACTIVITIES AND FELLOWSHIP AND WILL MAKE LIFELONG FRIENDS.  PLEASE FILL OUT THIS FORM AND INCLUDE  $16 ANNUAL NON-REFUNDABLE MEMBERSHIP FEE AND MAIL TO THE ADDRESS BELOW OR DELIVER TO A MEMBER OF THE BOARD.

ACTIVITIES AND VARIOUS FUNCTIONS OF OUR GROUP ARE CONDUCTED THROUGH COMMITTEES AND VOLUNTEERS.  IF YOU WOULD BE INTERESTED IN SERVING ON ONE OF THE COMMITTEES OR SPONSORING AN ACTIVITY, PLEASE CHECK BELOW: 

____BOARD MEMBERSHIP                                                                    ____MEMBERSHIP COMMITTEE
____ACTIVITIES COMMITTEE                                                                ____PUBLICITY COMMITTEE
____FINANCIAL COMMITTEE                                                                ____SPONSOR AN ACTIVITY

PLEASE PRINT LEGIBLY

NAME:__________________________________________  BIRTHDAY:___________/_____________
                   
   (MONTH AND DAY ONLY)
ADDRESS:_______________________________________  HOME PHONE:________________________
____________________________________________
CITY                                                   STATE                  ZIP
WORK PHONE:________________________

______/_____/________
APPLICATION DATE

Email Address:
_________________________
(To be added to the Speak Easy Notification Email List - TOPICA)
I certify that I am at least 21 years of age

________________________________
SIGNATURE

Please Check    ____NEW       ____RENEWAL               ____CASH        ____CHECK

PLEASE COMPLETE ENTIRE MEMBERSHIP APPLICATION AND RETURN 
WITH
$16.00 CHECK OR MONEY ORDER TO
 
(PLEASE DO NOT SEND CASH IN THE MAIL):

SPEAKEASY SINGLES
P.O. BOX 8717
SOUTH CHARLESTON, WV  25303


MEMBERSHIP PRIVILEGES INCLUDE RECEIPT OF THE MONTHLY NEWSLETTER 
AND DISCOUNTS ON SOME ACTIVITIES.  INVITE A  FRIEND TO JOIN.

For more information about the Speak Easy Singles Organization in the 
Charleston, West Virginia area

please contact:

speakeasysingles@suddenlink.net

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