Membership Application

Date:  _____________ New_____ Renew_____

Name:  _______________________________
            please print   (last)                (first)

Birth date:  _____________________________
                             (year not required!) 

Moved from:  __________________________

Spouse's name (if applicable):  _____________

Address:  _____________________________

_____________________________________

Telephone :  ___________________________

E-Mail:  _______________________________

You will receive your Newsletter by e-mail instead of U.S. Mail unless you specify otherwise by checking here:  ______

You will be contacted by e-mail instead of telephone unless you specify otherwise by checking here:  ______

Please make your check payable to Carlisle Area Newcomers Club and mail with this form to:

Carlisle Area Newcomers Club Membership
P.O Box 1134
Carlisle, PA  17013

(or turn the check & form in at a General Meeting)

Activities and Interests

1.  Check your interests:
     (  )  Book Discussion
     (  )  Bowling
     (  )  Bridge  (  )  evening  (  )  day
     (  )  Bunco
     (  )  Canasta  (  )  evening  (  )  day
     (  )  Dining In
     (  )  Dining Out
     (  )  Green Thumbs Gardening Group
     (  )  Investment Club
     (  )  Out-to-lunch Bunch/Day Trippers
     (  )  Pinochle  (  )  evening  (  )  day  
     (  )  Singles
     (  )  Stitch 'n' Chat
     (  )  Tennis
     
2.  Our members help organize club activities.  Please
     check how you would like to help:
     (  )  Civic/Community Outreach
     (  )  Historian  
     (  )  Hospitality (monthly greeter at meetings)
     (  )  Membership
     (  )  Memorial Project
     (  )  Newsletter
     (  )  Parliamentarian  
     (  )  Publicity  
     (  )  Refreshments Committee
     (  )  Socials (ex.:  Super Bowl Party)
     (  )  Sunshine/Helping Hands 
     (  )  Telephone/E-mail Committee
     (  )  Ways & Means (Fundraiser)
     (  )  Website  

3.  Our club by-laws require each member to   
     contribute refreshments once a year or serve
     as a committee member.