Clan Cameron - Stone Mountain, GA.

"WARNING" Do Not Try To Email This Form. It Won't Work! (YET!)

Dues must be paid every october

MEMBERSHIP

Dues: Individual or Family $20.00(Children under 21 included)

        Questions that have a * following the question are required to be answered.


New member:
Renewal:
Gift Membership:

Date: *

Mr. Mrs. Miss: *

Name: *

Last Name: *

Spouse's name:

Address: *

Address#2:

City: *

State: *

Zip code: *

Phone numbers:
Home: *
Work:
FAX:
Cell phone:
Beeper number:

(If don't have an email address, please put "Don't have one" in the 2 boxes below.)

Email address: *

Repeat email
address: *

Occupation:

Spouse's
occupation:

Additional people that you want a membership card for:

Special skills or talent:   

Previous Clan Cameron Affiliation:   

Previous Clan Affiliation(s):   

Will/do you participate in a Clan Committee?:  YES     NO

Do you attend (or did you attend) Clan meetings ?:  YES     NO

List of other things that you could offer to Clan Cameron:  

 

 

 

 

 

© VR Enterprises
Stone Mountain, GA.