2022-2023 HSC Membership Application

Hanscom Spouses Club

Membership Application Form 2022-2023
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
Phone Number

Area Code Phone Number
Spouses Name

First Name Last Name
Status of Spouse *

Active Duty Retired Deceased GS Civilian DBIDS Cardholder residing on HAFB
Spouses Rank and Branch of Service
Publish my contact information in the HSC directory:

Yes No
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 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, 2023. *Dues are prorated twice per year. Please see website for prorated rates beginning in January.
Please Select:
prev next ( X )
E1-E4 / GS1-GS4 $ 12.00

E5-E6 / GS5-GS9 / Seniors (62+) or widows $ 24.00

E7-E9 / O1-O2 / W1-W5 / GS10-GS11/DBIDS Cardholder residing on HAFB $ 36.00

O3-O9 / GS12-GS15 $ 48.00
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