THE AMHERST CLUB
Application for Membership
Please return the form to the chair of the Membership Committee for review by the Committee. Applications are then considered for approval at the monthly meetings of the Board of Directors.
Name of applicant: ____________________________________________
Home address: _________________________________________________
Home phone: ______________________ Work phone: ______________________ Email: __________________________
Work/Organization: ____________________________________________
Current/ Past Service to the Community:
________________________________________________________________ ________________________________________________________________ _______________________________________________________________
All of us participate in several functions of the Club. What kinds of activities would you like to be involved in? (For example, committee activities include getting speakers for lunch, Love Notes planning, Club social activities, newsletter and web site, working on projects for the community). Other activities?
The Amherst Club, P. O. Box 2002, Amherst, MA 01004-2002
Three categories of membership, for which quarterly dues are billed, are: Full, Associate, and Partnership.
Please use a separate form for the second member of a partnership
Full Membership $100 per quarter Associate Membership $30 per quarter Partnership Membership $115 per quarter
Guest Luncheon Fee $13 per luncheon
Full membership includes all luncheons.
Associate membership is an option for those unable to attend Tuesday meetings regularly. Dues include one lunch per quarter. These members attend additional lunches by paying the guest fee.
Partnership membership is a membership shared by two people. Either may attend any luncheon, but if both attend the same meeting, one guest fee is paid.
Check category: Individual ____ Partnership ____w/_______________ Associate ____
What else would you like us to know about you and your interests?
References (2) Include address, phone, and email:
1.
2.
Board action: ____________________________ Date: ___________________
Revised October 2010 |
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Application Form |