Circle one: NEW Members ~ $40.00
Austin
Newcomers membership year is August 1st through July 31st. Membership continues as long as annual dues are paid. One membership fee
includes all persons living in the household address given below. To be eligible for membership in Austin Newcomers Club, individuals
must 1) reside within the 787- - zip code area; and 2) abide by the by-laws of the Club, including no commercial solicitations.
Circle
one: RENEWAL: $35.00 Late Fee Due: $5.00 (Due after October 1, 2011)
The renewal period begins in July and continues through September, after which
time membership will be considered cancelled. To be included in the Membership Directory, members must have joined or renewed
membership by September 30th. From October 1st to December 31st, membership may be reinstated by paying annual dues
plus a $5.00 late fee. After December 31st, all non-renewals will be purged from the membership rolls and you must rejoin as
a new member. Please send this form completely filled out for renewal processing.
Name #1 and Address/City/Zip are required. Other information you provide is eligible for printing in the Newsletter and Directory (sorted by Name #1). All information
is to be used solely for Club purposes. Please print clearly.
Name #1: ________________________________________Birthday
#1: _____________________
(month / day)
Name #2: ________________________________________Birthday #2: _____________________
(month / day)
Address: ________________________________________________________________________
City: ____________________________________________Zip Code: 787_______-________
Phone: _________________________ Cell
Phone: ______________________
E-mail Address: ___________________________________________________________________
From
where did you move? __________________________ When? _________________________
What brought you to
Circle
how you heard about Newcomers: Internet website Friend/Neighbor Radio/TV
Belonged to Newcomers elsewhere Austin American-Statesman
Neighborhood Newsletter Other (specify): ________________________
(For statistics only) Circle the group that best represents your age profile: 20-35 36-50 51-65 66+
By submitting this application, you agree to adhere to
all the by-laws of the organization, including a provision that the
Signature #1: _____________________________________Date: ________________
Signature #2:
____________________________________ Date: ________________
Please make your check payable to Austin Newcomers Club and
mail with this form to:
Deidre Brightman
Newcomers Membership