PO Box 2002

Amherst, MA 01002

Text Box:



Application for Membership


Please return to the Chair of the Membership committee.  Applications are considered at the monthly meetings of the Board of Directors.  You may also mail the application to the Membership Committee at the address above.


Name of Applicant:




Work Phone:                                  Work Email:


Home Address:


Home Phone:                                 Home Email:



Current/Past Service to the community (in Amherst and, if new to the area, in other communities).







All club members 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, working on fundraising, club social activities, newsletter and web site, working on projects in the community, etc.












Two categories of membership*, for which quarterly dues are billed, are Individual Memberships @ $75 per quarter (all luncheons included) and Associate Memberships @ $30 per quarter (one lunch per quarter included; additional lunches @ $14).  Note: there is a guest luncheon fee of $14 per luncheon. We currently meet on the 2nd and 4th Tuesday of the month.


Check membership category:   Individual ____  Associate _____



What else would you like us to know about you and your interests?























*Numbers are valid as of August 2016 and may change on a quarterly basis.