Seasoned & Single Membership Application
Please print, fill out, and fax or mail. |
| Title |
____ Ms. ____ Mr. |
| First Name |
|
| Last Name |
|
| Nickname |
|
| Address |
|
| City, State, Zip |
|
| Home Phone |
|
| Cell Phone |
|
| E-Mail Address |
|
| Marital Status |
____ Single ____ Divorced ____ Widowed ____ Separated |
May we use your candid photo on our web site and/or in our printed materials?
____ Yes ____ No |
I would like my E-Mail address listed on the private member directory:
____ Yes ____ No |
Please send me event offerings by regular mail, as I don't have E-Mail:
____ Yes ____ No |
Annual Membership $180
Renewal Membership $150
(may be paid annually or semi-annually)
Note: Reservations made 2 weeks in advance receive 10% off price. |
Make checks payable to: Seasoned and Single
Remit check or money order to:
Seasoned and Single
P.O. Box 1715
Hayden, ID 83835 |
| Membership cancellation: You may cancel your membership within three days of the date of your application, providing that no events were attended during that time. Then you will have started enjoying member benefits and therefore cannot rescind membership and no monies will be refunded. |
I have read and understand the terms of the Seasoned and Single membership. My signature certifies that I am single or separated and the information contained in my membership application is accurate.
Signature _________________________________ Date ______________
|
