Name:___________________________________________________________ Address:_________________________________________________________ Email address:_____________________________________________________ Home phone:_______________________Mobile:__________________________ Moved here from:___________________________________________________ Years residing in area:________________________________________________ Spouse/partner:____________________________________________________ Birthday:_________________________________________________________ I am interested in the following activities: Birthday Lunches___ Bocce Ball ___ Book Club___ Movies and More___ Writers' group___ Game Day__ Girls' Nite Out ___ Hiking ___ Mah Jong ___ Do you have a special talent/interest you would like to share with the group? Please tell us all about it!__________________________________________________________ ________________________________________________________________ The membership fee is $30/year. You have the option of printing this form and bringing it to your first coffee morning or when meeting with the membership chair.
