Name(s):_________________________________________________________
Address:_________________________________________________________
City, State,
Zip:____________________________________________________
Home
Telephone:______________________Fax:_________________________
Work Telephone
1:__________________Work Telephone 2:_________________
Cell
Telephone 1: ___________________Cell Telephone 2: _________________
E-mail 1:_________________________
E-mail 2:_________________________
I have included changes to my: q
name q
address q
home telephone
q
work
telephone
q
e-mail
q
fax
q
Please include
q
Please do not include
-
my office number in the yearbook.
Membership is for January 1 -
December 31, 2005 and includes International dues ($15.00 household or
$10.00 individual), local dues and bimonthly newsletter, and Friendship
Magazine ($15.00)
MAKE ALL CHECKS PAYABLE TO FRIENDSHIP FORCE OF DALLAS.
Enclosed is:
q
$40.00 for a single membership
q
$45.00 for a household
membership
q
$15.00 for a secondary membership (have membership in another
club; no magazine)
q
I do not want Friendship Magazine; I have deducted $15.00
q
I would like to order (#)______Friendship Force badge/s:
$5.50 per badge
(Include it in your membership check or order separately.)
Name(s)
as you would like to have it /them appear on the badge(s):
_____________________
_____________________
City as you would like to have
it/them appear on each badge:
_____________________
I
would be willing to help the
Friendship Force of Dallas AT SOME TIME IN FUTURE AS:
q
Home host for visiting ambassadors
q
Day host for visiting ambassadors
q
An ambassador - visit a foreign country
q
An interpreter - Language: ___________________
q
Helper with hospitality/ set up/greeter for meetings
q
Helper on telephone committee
q
Helper mailing newsletters
q President (coordinates the overall club activities)
q Vice-President (assists President and handles conferences, etc._
q First Vice-President (membership)
q Second Vice-President (programs)
q Exchange Director - (Inbound)
q Assistant to Exchange Director - (Inbound)
q Exchange Director - (Outbound)
q Exchange Director - (Inter-Club)
q International Exchange Coordinator