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NEWCOMERS CLUB OF DOVER, DE
Membership Profile Form
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Please print |
Date: |
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Name |
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Street Address
Town/zip code
Subdivision |
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How long at this address? |
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Mailing Address
(if different from above) |
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Birthday (Month and day only) |
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Telephone (home)
E-mail address |
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Are you employed outside the house?
If so, where?
Business telephone number |
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Are you retired? From where?
What was your position? |
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Marital status; Spouse |
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List names and ages of children living at home |
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City and state of last residence |
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Reason for moving to Dover |
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Special interests and hobbies |
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Club activities in which you would like to participate |
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Have you ever been a Newcomers Club member elsewhere? Where? How long were you a member? Did you hold an office? |
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How did you learn of Newcomers of Dover? |
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Would you like to receive your newsletter by regular mail or email _______________________
Please submit this form with your check for $10, payable to “Newcomers Club of Dover” to:
Lorraine Powel
206 India Drive
Smyrna, DE 19977
If you have any questions, please call Lorraine at 653-1853.
Note: Membership dues will be $10.00 per year. If paid after June 30th, dues will be $12.00.
A new member pays $10.00. If joining after January 31st, dues will be $5.00 that first year.
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