We are pleased that you are interested in joining our group and hope you will enjoy our activities and fellowship
and make lifelong friends.  Fill out this form and include $16.00 non-refundable membership fee and mail to above
address or bring to an activity with you.  Activities and various functions of our group are conducted through
volunteers.  If you would be interested in sponsoring an activity, please note your interest or talk to a Board Member.

NAME:_______________________________________________  Birthday _______________    ______

                                                                                                                                    Month                   Day

ADDRESS:____________________________________________________________________________

City/State/Zip: __________________________________________________________________________

Home Phone ________________ Email: _____________________________________________________

I certify that I am at least 21 years of age: 

_____________________________________________________________      ______________________

                              N  A  M  E                                                                                        D A T E 

I am interested in the following activities or helping by volunteering to do these activities:

______Dances   _____ Picnics    _____Newsletter   _____ Membership Drive   _______Wherever needed!