Alano Club Member Form

Club Membership Registration

Thank you for applying for membership to The Alano Club. The process requires a current member to endorse your application with his/her signature below . Also, the initiation fee and first month's dues ($30.00 total) must be attached and the following information provided. At the next regularly scheduled meeting of the board, which is monthly on the third Tuesday of every month at 6 p.m., your application will be brought forward for consideration. If for some reason your application is denied, your money will be refunded.
All areas must be filled out completely.
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.Format: (000) 000-0000.
Date*

MonthDayYear
Date
Once you submit your online application, please note that fees can currently only be paid in person at the Alano Club.
We kindly ask that you make your payment before the next monthly board meeting.

Fees:
Initiation Fee: $10
First Month’s Dues: $20
Total: $30

You will be contacted shortly to confirm your membership once your application has been approved.

Thank you!
Should be Empty:

Club Membership Registration

Club Sponsor Information