Empowering Educators On-Line Member Invitation
Optimist Club
Name
HOME ADDRESS
Street
City
State/Province
ZIP/ Postal Code
Home Phone
Cell Phone
E-mail
example@example.com
SCHOOL INFORMATION
School Name
Type of School
Street
City
State/Province
ZIP/ Postal Code
Work Phone
E-mail
example@example.com
Position or Title
May we contact you at work
No
Yes
YOUR SIGNATURE INDICATES YOUR ACCEPTANCE OF THIS INVITATION
Signature
Date
/
Month
/
Day
Year
Today's Date
Op
ti
mist Interna
tiona
l
15400 Grand River, 2nd Floor Detroit, MI 48227
www.eeol.org
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