MEMBERSHIP APPLICATION FORM

Applicant name: ______________________________________
Date of birth: __________
Address: ____________________________________________
Phone: __________________ Email: _____________________

Membership type: ____________________________________
Start date requested: ________________________________

Why would you like to join?
_________________________________________________

Interests / activities: ______________________________
Emergency contact: __________________ Phone: __________

I agree to follow the organization's applicable rules and policies.
Signature: ____________________ Date: _______________