Type of Membership

Household

Senior (65+)

Name

First Name

Last Name

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Kids in your household?

Under 10 years

Over 10 years

Baby-sitting Co-op?

Would you be interested in joining a baby-siting co-op if we created one?

You bet! Sign me up

Nope, thanks - Got it covered

Interests

Do you have a new found interest or passion? Would you like to meet other members that share it? Here are few ideas to get the wheels turning...Biking, Gardening, Home schooling, Photography, Beer brewing, Quilting, Car restoration, Painting, Star gazing/Astronomy, Camping

Skills

Do you have a skill or expertise that you'd enjoy sharing with the club? Special event planning... Project management... Grant writing?

Any additional info you'd like to share?

Partner

And last but by no means least...Is there a second adult in your household? Please include his/her name here.

First Name

Last Name

Partner's Email

Sunset Heights Civic Club

Membership form