Soroptimist International                       Soroptimist International of South Lake Tahoe

                                     Application for Membership

                                                  

                                                        PLEASE PRINT CLEARLY USING BLACK INK

 

 

NAME__________________________________________________________________________________________________________

 

FIRM NAME ___________________________________________________________________________________________________

 

TITLE OR POSITION HELD _____________________________________________________________________________________

 

NATURE OF BUSINESS _________________________________________________________________________________________

 

BUSINESS PHONE ___________________________________________________

 

BUS. FAX ___________________________________________________________

 

BUSINESS MAILING ADDRESS ________________________________________________________________________________

 

BUSINESS PHYSICAL ADDRESS _______________________________________________________________________________

 

BUSINESS E-MAIL ADDRESS __________________________________________________________________________________

 

Other Business Interests (please describe)___________________________________________________________________________

 

HOME PHONE _________________________________     HOME FAX _________________________________________________

 

HOME MAILING ADDRESS ___________________________________________________________________________________

 

HOME PHYSICAL ADDRESS __________________________________________________________________________________

 

HOME EMAIL ADDRESS _____________________________________________________________________________________

{Please mark (**) the contact information you would like Soroptimist to primarily use}

 

Would you like your birthday listed in the Newsletter?    YES                NO                  Month_____Day______

 

FAMILY MEMBERS:_____________________________________________________________________________

 

 

ORGANIZATIONS / AFFILIATIONS / OTHER INTEREST____________________________________________

 

                                    ________________________________________________________________________________________________

 

 

Mail application to:

SISLT

P. O. Box 2179

                            Stateline , NV 89449

 

To be completed by Soroptimist Sponsor.  APPLICANT NAME:  ______________________________________

 

Sponsor:

 

 

How long have you known this person? ___________________

 

How do you know the applicant?

 

 

To be completed by Recruitment and Retention Committee.

 

Date Application Received

 

 

Date Presented to the Board

 

 

Recruitment & Retention Comm.

 

 

Date Letter of Invitation Sent

 

 

Orientation Date

 

 

Induction Date

 

 

Attendance Committee Notified

 

 

Newsletter Notified

 

 

Roster Notified

 

 

Treasurer Notified

 

 

Fees Paid

 

 

Committees

 

 

 

 

Classification:

 

Index Number:

 

Membership Type: