(Jan Prorated Form) HSC Membership Application 2020/2021

Hanscom Spouses Club

Membership Application Form 2020-2021
Select one:

New Member Renewal
Name

First Name Last Name
E-mail
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Home Number

Area Code Phone Number
Cellular Number

Area Code Phone Number
Spouses Name

First Name Last Name
Spouses Rank and Branch of Service
Status of Spouse

Active Duty Retired Civilian Deceased
Publish my contact information in the HSC directory:

Yes No
How would you like to receive the Yankee Flyer newsletter?

E-mail Only E-mail and Printed Copy
Volunteer Opportunities (please check areas of interest and see the HSC website for more info)

Minute Man Thrift Shop Childcare Coordinator Scholarship Fundraiser Scholarship Awards Committee Programs (Events) Team Publicity/Historian Team Hospitality Team Yankee Flyer Newsletter (delivery, advertising, editing) Youth Activities Call for help as needed Serve as Board member
Activity Groups (please check the HSC website for current groups)

Associates Book Club Coffee Break Spouses Night Out Community Service Create Your Own Group
Annual Membership Dues

Please select the corresponding membership type below to pay with a credit card or directly from your checking account via Paypal. Membership will expire August 31, 2021. *See prorated dues below for Jan 2021.
Please Select:
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E1-E4 / GS1-GS4 Free

E5-E6 / GS5-GS9 / Seniors (62+) or widows $ 18.00

E7-E9 / O1-O2 / W1-W5 / GS10-GS11 $ 27.00

O3-O9 / GS12-GS15 $ 36.00
Signature
Signature date
For more information please contact membership@hanscomsc.org
Should be Empty:

Hanscom Spouses Club

Annual Membership Dues

For more information please contact membership@hanscomsc.org