TRIANGLE SINGLES’ CLUB MEMBERSHIP APPLICATION FORM

Membership Dues: $25.00 Annual Renewals: $25.00
Name:		E-Mail Address:
Address:
City: State: Zip:
Home Phone:		Work Phone:
 Single  Widowed  Separated  Divorced			 Previous Member		Birthdate:
Who Can Attest To Your Single Status?
Name: Address:				Relationship:
My hobbies and major interests are:
PUBLICITY/COMMUNICATION - Indicate interest in assisting with the following:				TALENTS - Talent you would like to share with your friends at Triangle Singles?
 Newsletter mailings  Send e-mail reminders to members  Web Site design  Maintain web site  Create fliers  Distribute fliers  Hosting an Event  Graphics Design  Available Home/Clubhouse for Club Activities				 Singing  Musical instrument  Photographer  Dance instruction  Acting Other____________________ ________________________
Music – Do you prefer: □ Country □ Rock  Swing  Beach Music  Popular/Top 40 Other___________________	Dancing – Do you prefer:  Shag  2 Step  Slow  Line Dancing  Freestyle  Swing Other _______________			Assistance: How would you like to help? Work on one of Host Teams (greet people, dance w/guests, keep refreshment table filled, clean-up)  Yes  No  Train to be a DJ--- Yes  No  Work the door (collect $, sign in) Yes  No 
Signature: ______________________________________________				Date: _______________________
(FOR CLUB USE ONLY) Membership Approved By: __________________ Office: Date: Date Posted: ________________________