Member Application

Membership Application

(or Update to Current Membership Information)
Full Name*

First NameMiddle InitialLast Name
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Partner/Spouse Name

First NameMiddle InitialLast Name
Are You Employed?

YesNoRetired
Occupation (Current/Previous):
Do you have any children?

YesNo
If yes, how many?
Do you have any grand children?

YesNo
If yes, how many?
Hometown:
Number of Years in Florida?
How did you hear about us?*
If invited by a member, who?
Interests and Talents
Do you Play a Musical Instrument?

YesNo
If yes, which instrument(s)?
Do you Paint, Sew, or enjoy Crafts?

YesNo
Tell us more specifics?
Do you have Computer Skills?

YesNo
Tell us more specifics?
What are your hobbies:
What are you passionate about :
What clubs / organizations do you belong to and what offices have you held?
Mission
The mission of GFWC clubs is community improvements through volunteer service. We achieve this mission through the committee structure. Each club member serves on at least one committee and participates in meetings, decisions and hands-on projects that relate to that committee. There is currently one - two mandatory Fundraisers each year.
Disclaimer and Signature
Dues are $60 per year. Dues can be paid by Cash, Check, or Online.

Check: Make check Payable to SLJWC and turned in at a meeting or mailed to SLJWC Membership, PO Box 121411, Clermont, FL 34712

Online: Link for Square payment will be provided once application is Submitted. A fee is charged by Square for use of service and is included in payment on the payment screen.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Membership Application

Interests and Talents

Mission

Disclaimer and Signature