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Membership Form

Newcomers Club of Harford County

Membership Form for new members and current members with changes

Please mail completed form along with dues  $10/year to:

The Newcomers Club of Harford County
Attention: Membership
P.O. Box 115
Bel Air, MD 21014

NOTE: The information collected on this form is for 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.

NEW MEMBERS ONLY

PLEASE PRINT

Date: _______________________________________________________________________________________

Member's Name:_____________________________________________________________________________

Spouse's Name:______________________________________________________________________________

Street Address:______________________________________________________________________________

City/State/ZIP: ______________________________________________________________________________

Moved Here From: ____________________________________________________________________________

Member's Birth Date (no year!) ________________________________________________________________

Your Interests/Talents:________________________________________________________________________

______________________________________________________________________________________________

Home Phone __________________Cell Phone ____________________________________________________

Email ________________________________________________________________________________________

RETURNING MEMBERS, IF ANY CHANGES:

Date: __________________________________________________________________________________________

Member's Name ________________________________________________________________________________

Spouse's Name _________________________________________________________________________________

Home Phone ____________________Cell Phone ____________________________________________________

Email ___________________________________________________________________________________________





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