The Newcomers’ Club
of
Membership Application/Renewal Form
Personal
Information:
Name:
________________________________________________________
Address:
_______________________________________________________
City:
____________ Postal Code: _________ Community: ______________
Email
Address: _________________________________________________
Phone
#: Home: ______________ Office: _____________ Cell: ___________
Birthday:
Month: ____________ Day: _____________
Age
Group: (please circle) under
24 25-34 35-44 45-54 55-64 65+
Children: How many? ____________ Ages:
_________________
Spouse
(if applicable)____________________
Date
Arrived: ____________________ Moved from: ___________________
How
did you hear about NCE? ______________________
New Members only – Tell us about yourself: (hobbies and
skills such as knitting, skiing, golfing or others. Your
message will be included in the newsletter so other members with similar
interest can get in touch with you)
__________________________________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Liability
Waiver:
By
signing this enrolment form, I agree to hold the Newcomers’ Club of Edmonton,
its Executive and members harmless from any potential injury or other grievance
that may arise during the normal course of social events or interest group
activities held by or organized for the members of this Club.
Signature:
________________________________ Date: _____________
Privacy of
Information:
The
Newcomers’ Club of Edmonton collects your name, address, telephone number and
other pertinent information for the sole purpose of notifying you of club
events. We will send you a monthly newsletter and provide a members’ roster
only to paid members of our club. We do not sell or disseminate to other
entities .I agree to the above use of my personal information, and also agree
to keep the Club Roster confidential, not using it for purposes outside Newcomers Club of Edmonton business.
Yes,
please include me on the NCE Club Roster & Members List
(If
you have any concerns regarding your personal information please bring them to
the attention of our Membership Director.)
Signature:
_______________________________Date:_____________
Cheques
Payable to: The Newcomers’ Club of Edmonton- cheque # __________
Mail
to: Membership Secretary, Newcomers’
Club of
Fees:
______ New Membership (enter
amt.) ________ Renewal Membership (enter
amt.)
|
Membership
Fee (includes a name tag) |
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