Name *

First Name

Last Name

Address *

Address or PO Box

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

For USA, enter "1" in Country Code or leave blank

Country

(###)

###

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Cell Phone

For USA, enter "1" in Country Code or leave blank

Country

(###)

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Opportunity Questionnaire

There are many opportunities for you to play a vital role in planning and participating in the work of the club. Please check the list below and mark those items which are of a special interest to you and return it with your dues check.

Communications Committee (Website, Publicity, Emails, etc)

Working with the Scholarship Committee

Assisting with End of Year Banquet

Helping with Grace Moore Scholarship Fund Raising

Soliciting Yearbook ads

Serving on the Hospitality Committee

Serving on the Telephone Committee

Seeking new members

Contact preference *

How do you wish to be contacted by the CMC? Please check all that apply

Email

Home Phone

Cell Phone