SIR

Please return this form to: billhockenson@gmail.com or mail to Bill Hockenson, Membership Chair, SIR Branch 19 292 Windstream Place, Danville, Ca. 94526

SIR's Mission is to improve the lives of our members through fun activities, luncheons and events while Making Friends for Life

First Name

Initial

Please Print the Following Information Clearly

Name

Partners NameLast Name

Nickname

Address

Home Address Street Apt

Street Address Line 2

City State

Zip Code

Address

Mailing Address If Different

Street Address Line 2

City State

Zip Code

Mailing Address (If Different)

E Mail Address

Birth Date

Date

Area Code - Phone Number

Emergency Contact Name

Relationship

Area Code - Phone Number (other than your cell phone)

Branch 19 Contact Directory: With your permission, SIRs Branch 19, will put your name, address, phone number and partner's name in a directory that is to be distributed to other members to enhance communication. This directory will be updated and distributed annually. | Don't Give Permission I Give Permission

Signature for Yes

Signature for No

How did you hear about SIR?

I am applying as a New Memberam aTransferring Member from Branch

] I am applying [as a New Member| am a[]Transferring Member from Branch #

The following information will help us introduce you to new friends and make you aware of our many activities:

FormerCurrent Occupation

With Company or Organization

Applicants Signature

Date

Sponsors Name

Sponsors Badge Number

For Membership Chairman's Use Only:

Approved by Branch Executive Committee A Branch Official will contact you soon regarding the next step in the process.

Approved by Branch Executive Committee

Installed as a Member

Badge

Name

Please check those activities and/or interests that you would participate in now or in the future. Our Branch has many of these, and others may be available in our Area. Should you be passionate about an activity that is not available, you will be given assistance in starting it. That's a great way to meet people. Many of these activities allow your partner can be involved in SIR too. ACTIVITIES LIST (An 'P' after an activity indicates that Ladies can participate) ChorusPinochle Antique CarsExplore & Eat CoinsFishingPoker Astronomy BackgammonComputers & TechPool - Billiards Football Day Barbershop QuartetPool - Table Game Night Computer Training Cooking - GroupGardeningRacing Day Baseball Day Recreational Vehicles BikingCooking - HostGenealogy Book ClubCrab FeedGin Rummy Singing Book SwapCribbageGolfStamps BocceHiking - ExperiencedTravel Dancing Hiking - EasyWine Bargains/Finders BowlingPhotography Bowling, LawnDinner DancesHorseshoesWine Tasting Breakfast Club Woodworking BrewingDine Out - GroupModel RailroadWrite Auto-Biography Bridge - BasicDominoes - RegularMusicianVeterans Bridge - DuplicateDominoes - Mex TrainMusicians - GroupYoga ChessEconomic StudyPickleball Other areas of interest not listed above:

Other areas of interest not listed above

Ways you can assist the Branch: Please check those that interest you. Computer LeadershipLuncheon Help

Luncheon Coordinator Audio/Video

Newsletter Prep Newsletter Editing Database Spreadsheets

Other Training Photographer Photo Editing Auditing Special Events Assistant Budget Planning Pianist

Branch of Service

Year Joined

Year Discharged

Highest Rank

Special Awards

Served During Specific War or Conflicts

Other Information about yourself that you would like us to know:

SIR

APPLICATION FOR SIR MEMBERSHIP

VETERAN DATA