Jugs Social Club Membership Application

Jugs Social Club Membership Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Names of current Jug Members you know:*
Have you participated in the Krewe of NOMTOC parade?*

YesNo
Have you or a family member participated in a Royal Court of the Krewe of NOMTOC?*

YesNo
Have you been an active supporter of Jugs/NOMTOC activities?*

YesNo
If yes, which activities?
Why would you like to join Jugs Social Club?*
If selected, interviews will be scheduled from 11/17 through 11/22
Should be Empty:

If selected, interviews will be scheduled from 11/17 through 11/22