stonecrest swim club application
DESCRIPTION
2012 applicationTRANSCRIPT
sfo 6/12/2012
STONECREST SWIM CLUB 2012 APPLICATION FOR MEMBERSHIP
Last Name: _________________________________ First Name: _________________________________ Dr./Mr./Mrs./Ms./Miss (circle one) Occupation: ______________________________________ Last Name: _________________________________ First Name: _________________________________ Dr./Mr./Mrs./Ms./Miss (circle one) Occupation: ______________________________________ Phone: ___________________________ Email: _______________________________________________ Address: ________________________________________________________________________________ City: ___________________________________________ State: _______ Zip: _____________ List the names and birth dates of your dependant children who reside at the above address: Name Birth date Name Birth date
_____________________________ __________ _____________________________ __________ _____________________________ __________ _____________________________ __________ _____________________________ __________ _____________________________ __________ Indicate the names of any club members with whom you are acquainted: ________________________________________________________________________________________ How did you hear about Stonecrest? ________________________________________________________________________________________
There is an application fee of $25.00 which is non-refundable.
Please make your check payable to: STONECREST SWIM CLUB and mail with this application to: Joe Starner Membership Director 2235 W Woodlawn St Allentown, PA 18104
For more information, please visit our website: www.stonecrestswimclub.com I hereby make application for membership to Stonecrest Swim Club, Inc. and, if elected to membership, I agree to subscribe to and abide by the provisions of the rules and regulations of the club as set forth by the Board of Directors. __________________________________________ _______________________ Signature Date
For use by membership chair: Date rec’d: _______________ Bond due date: _______________ Dues due date: _______________