Application for Membership

Please fill in all fields of the form.

First Name:    Middle Initial: Last Name:

Address:        City:         State:   Zip:

Phone #       Email Address:    Sponsor's Name:

Marital Status:                       Date of Birth:

Names of other Clubs that you are a member of:

Have you ever been refused membership or expelled from any other Colts Corral/Ravens Roost?  Yes   No

Ever refused membership or expelled from any other club?   Yes   No

If yes, please explain:

Are you a season tick holder?  Yes  No

Are you willing to support out of town trips?  Yes  No

Are you willing to work for the interest of the club?  Yes   No

What to you expect to bring to the Club?

What do you expect in return from the Club?
 

If accepted for membership in Ravens Roost #73 you will, at all times, uphold the Constitution
and by-laws of the organization.

Annual dues are $25.00 and are due at time membership is accepted ($40.00 for couples).

The Membership Committee will hold all of the information supplied in this application in strict
confidence.

The information contained in this form will be printed out and provided to you for signature.