FALLBROOK NEWCOMERS MEMBERSHIP APPLICATION

Annual Dues $25.00 Magnetic Name Tag $6.50 (Recommended)

Club Year July 1^st to June 30^th

Membership Includes Spouse/Partner

Name__________________________________________ Spouse/Partner ____________________________________________

Last First Last First

Address___________________________________________________________________

Street City Zip

Phone_____________________________________________________________________

Home Cell

E-Mail________________________________________________ Birthday________________________

Month Day

Purchase Name Tag? Yes No

Include $6.50 with dues

Moved from_______________________________________ When? ___________/_________

State City Month Year

We share none of this information outside the club, but if there is any of this information that you would like

NOT to be printed in the Roster or Newsletter, please indicate that:

Meetings (Coffees) are 2^nd Thursday each month, 9:30 am, except July/August at the

Fallbrook United Methodist Church, 1844 Winter Haven Road, Fallbrook 92028

Make check payable to: Fallbrook Newcomers Club

Mail application to: Fallbrook Newcomers Club

P.O. Box 1392

Fallbrook, CA 92088-1392