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APPLICATION FOR MUSHAC CLUB MEMBERSHIP
(To be kept in MUSHAC club file) FORM NO:……..
NAME OF APPLICANT:……………………………………………………….
Address…
City……………………………..…
Phone:…………………………. Date of birth:…………………
E-mail:………………………………
Activities and Hobbies…………………………………………..
Other organizations
Of which I am a member:………………………………………..........
I, the undersigned, am in good standing in my school and/or community, and in accordance with the constitutions and bylaws of this club, hereby apply for membership
I believe the above information to be true and complete, and I desire membership in this club. I believe I can make a contribution to the club and be worthy of the friendship of its members. I understand the entrance fee will be…………… and the annual dues will be……………………….
……………………………………….. ……………………….
Signature of Applicant Date
To be completed by referee where referee sponsorship is required (must be MUSHAC member):
I hereby give sponsor for my friend to become a member of the above-named MUSHAC club
Referee name:……………………………………………………….
Address:………………………….….
City:…………………………………
…………………………… ……………………..
Signature of referee Date
Return Form To:
MUSHAC Club Chairman
Address: P.O, BOX 474
City: MOSHI
For MUSHAC Approved by:………………… ……………… ………
Use Only Signature Date
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