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 |
| Scrapbooking | Social Bridge | Walk Group |
| Wine and Cheese Night | | |
|
Suggestions for others: |
Please mail this form with your $20.00 (payable to Welcome Wagon Social Club)
to:
Sharon Kerns
1161 Bernard Drive
Reading PA 19605