2011 Mountain Island Shag Club Membership Application
www.mtn-island-shag-club.com
RENEWAL- $15 Before Feb. 1st NEW - $20
MEMBER NAME:____________________________________________________________________
ADDRESS:_________________________________________________________________
CITY:______________________________STATE:________________ZIP:____________
I prefer to receive phone communication via:___
HOME PHONE:_____________________ CELL PHONE:____________________
WORK PHONE:________________________
BIRTHDAY: MONTH:________________DAY:________________
E-MAIL ADDRESS:_________________________________________________________
OCCUPATION:_____________________________________________________________
COMMITTEES:
Please select (1) committee on which you are willing to serve this year:
( ) MEMBERSHIP-recruiting new members, keeping membership records, greeting
( ) SOCIAL- planning and coordination special events for the club
( )WAYS AND MEANS- promoting moneymaking projects for the club
( )FOOD- assist in planning menus for regular and special events
( )50/50- sell 50/50 tickets at regular and special events
( )SET-UP/DECORATE- help set-up and plan decorations for special events
( )INTERNET SKILLS- help maintain and update the club’s website
AMOUNT PAID: $______________
( )CASH ( )CHECK (PREFERRED- to MTN-ISLAND SHAG CLUB) Check No:_____
Mail to: MTN-ISLAND SHAG CLUB:1521 WESTDALE Rd, ,Charlotte, NC 28208 (or) Give Application to any Officer
SIGNATURE:_________________________________________DATE:______________
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