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Date: ___/___/___
Name: ____________________________________Spouse's Name:____________________________
Address 1:___________________________________________________________________________
Address 2:___________________________________________________________________________
City: ____________________ Zip: ________ Home Phone: _____________Cell Phone:_____________
E-Mail: ________________________________________ Moved From: __________________________
Birthday (month and day only): __________________________
Children's Names & Birth Dates: __________________________ ___/___/___ Children's Names & Birth Dates: __________________________ ___/___/___ Children's Names & Birth Dates: __________________________ ___/___/___ Children's Names & Birth Dates: __________________________ ___/___/___ Children's Names & Birth Dates: __________________________ ___/___/___
Please Check off Any Activities you are Interested In (Check all that apply):
Book Club - Daytime Pub Night Stitch & Chat
Book Club - Evening Lunch Bunch On the Town
Cooking Group Mah-Jongg Moms & Kids
Nine Hole Golf Socials Wine Tasting
Drop In Coffee Couples Euchre Men's Poker Night
Spontaneity Group Walk It Off
How did you hear about us? ______________________________________________________________________________________________ Any other comments?__________________________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ I would like the information contained on this form to be included in the Newcomers & Neighbors annual directory. Please make checks payable to Newcomers & Neighbors $40 annual membership fee - $20 from January 15th through May 31st. Mail to Stephanie Hamman, VP Membership, 416 W. Hickory Street, Hinsdale, IL 60521. Please feel free to call Stephanie at 773-525-3743. Database info and directory will not be released to non-members or be used for any purpose other than N&N notices (with Board approval).