Member Application... | The Monday Club

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THE MONDAY CLUB

APPLICATION FOR MEMBERSHIP

To: Members Of The Monday Club

Date

First name

Last name

Primary Phone Number

Other Phone Number

Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Birth palce

Date

Marital Status

Married

Unmarried

Wife's name

Date

Employer

Date

Occupation/Title/Retired

Education

High School

College

Degree(s) Earned

Religious Preferences

Church

Have ever been charged for a crime?

Yes

If 'yes' date and where

If convicted, briefly explain charges/disposition

Interests-Hobbies Skills

Other Affiliations (Assoc/Fraternities, Community Service, etc.)

Yes

If you were a Member. enter: year joined

Year departed

Reason

To become a member, you must provide the names of two sponsors.

Sponsor name

Sponsor Signature

Sponsor name

Sponsor Signature

Applicant Signature

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I agree to the new member application fee of $150.00+$1.50 as service charge. I understand that applications are subject to acceptance by the membership committee,

Membership Form$150