Application For Membership
OF FRESNO, CA
Application For Membership
OF FRESNO, CA
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Having formed a favorable impression of the Dante Club of Fresno, I, the undersigned, being of sound body and mind, of good moral character, 21 years or older, a citizen of the United States of America and descendent of an Italian father, hereby apply for membership to the Dante Club of Fresno..(A son of a father in the club can join at 18 yrs.) |
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Personal Data Name:_____________________________ Home Address:______________________ City:______________________Zip:______ Home Phone:______________________
Date of Birth:_____________________ Place of Birth:_____________________
Father’s Name:____________________
Father’s Address:_________________
City:______________________Zip_____
Occupation
Business Name:______________________
Occupation:_________________________ Address:___________________________
City:_______________________Zip_______
___________________________________ Applicant’s Signature
Membership Fee Deposited $_______________
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Recommended by: Two signatures required
1.___________________________________
2.___________________________________
Date:____________________
Wife’s Name:____________
E-mail:____________________
Cell:____________________
FAX:____________________
------------------------------------ Have you ever had any
Secretary |