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)
|
Book Club | Coffee Club | Daytrippers |
| Game Day | Golf |
Lunch Bunch |
| Lunching In | Movie Daze |
Night Out |
| Pinochle | Scrapbooking | Social Bridge |
| Walk Group | Wine and Cheese Night | |
|
Suggestions for others: |
Please mail this form with your $25.00 (payable to Welcome Wagon Social Club)
to:
Mary Lou Gavel
136 Hawthorne Court
Wyomissing, PA 19610