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WELCOME WAGON SOCIAL CLUB
MEMBERSHIP FORM


New Member Renewing Member Year Joined ______________

Name ___________________________________Address ___________________________________

Phone Number _________________________ E-mail Address ________________________________

Birthday Month/Day _________________________ Husband's Name __________________________

Children's Names/Ages _______________ ________________ _______________ ________________

Last Place of Residence _________________________ Hometown _____________________________

Special Interests ______________________________________________________________________

Would you be available to help with various committees? Yes No

Activities Offered: (circle those of interest to you)
Coffee Club Golf Movie Daze
Daytrippers International Cuisine Social Bridge
Friday Night Out Lunch Bunch Walk Group
Games Lunching In Wine and Cheese Night
Book Club Theater  

Suggestions for others: