Download - Civitan Lake Eola's Membership Form
Transcript
Membership Application
Name
Employer
Title Website
Address
Phone # (work) (cell)
(other)
Optional Demographic Information
Male Female Married Single Other
DD/MM/YYYY
I hereby request membership in Civitan Lake Eola...I agree to pay the sum of $25.00 as an initiation fee and pay the regular dues to the club, district, and Civitan International as billed by Civitan Lake Eola. With your dues, a complimentary subscription to The Civitan Magazine will be sent to you. Currently, dues have been decreased to be $25.00 per quarter.
Signature of ApplicantDate
Sponsor’s Name (who told you about us)
Welcome To Civitan! Mail: P.O. Box 3000, Orlando, Florida 32802
Email: [email protected]
Making a Difference. In Our Community
