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Membership Form

Please mail your completed for along with dues ($20 a year/$10 if joining for the first time between February 1 - June 30) to:
Newcomers of Harford County
ATTN: Membership
P.O. Box 115
Bel Air, MD 21014

NOTE: The information collected on this form is for the club and social use by club members ONLY.  Your name will not be used for solicitation purposes or distributed outside the club.  Please only list information that can be published in the club directory.


                                                                                        Date: _____________________

Member’s Name ________________________________

Spouse’s Name_________________________________

Home phone (________) ___________________ Work phone(________) _______________

Cell phone (________) ___________________ E-mail _______________________________

NEW MEMBERS, ONLY (Returning members, if any changes):

Street Address_________________________________________________________________

City__________________________ Neighborhood_________________Zip Code_________

Hometown ____________________________ Moved here from ______________________

Member’s birthday (no year!) __________________  Anniversary ______________________

Children’s names and birth years___________________________________________________

Your interests and talents ______________________________________________________

How did you hear about the club? If a member introduced you to the club, who?______________