Alano Club Member Form

Club Membership Registration

Thank you for applying for membership to The Alano Club.To complete the process, a current member must endorse your application. The initiation fee and first month's dues total $20. You will receive an email confirming that your submission has been accepted.
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Birth Date*

MonthDayYear
Sobriety Date

MonthDayYear
Date
Club Sponsor Information

I certify that this applicant meets the membership requirements as outlined in Article I, Section A and Section B of the bylaws. The club sponsor must be a member of The Alano Club in good standing.
Printed name of club sponsor*

First NameLast Name
Phone number of club sponsor*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Once you submit your application, we will contact you shortly to confirm your membership. You can conveniently pay the initial $20 fee online using the link provided in your confirmation email.

Thank you!
Should be Empty:

Club Sponsor Information