Junior Woman's Club

of Newport News

Application for Membership


JUNIOR WOMAN'S CLUB OF NEWPORT NEWS, INC.


Date - __________________________________________________

Membership Chairman:

I hereby apply for membership in the Junior Woman's Club of Newport News.

Name - _________________________________________________

Spous's Name - _________________________________________

Address - _______________________________________________

_______________________________________________________

Telephone; (Home)_______________ (Work)__________________

E-Mail Address - __________________________________________

Age - ______________ Date of Birth - ________________________

Registered Voter; Yes _____________ No ____________________

Occupation - ____________________________________________

Where Educated - ________________________________________

Past Club Experience - _____________________________________

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Special Interests in Club - __________________________________

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Signature _______________________________________________