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OPTIMIST CLUB OF CAMILLUS, NEW YORK, INC. P.O. Box 33 Camillus, New York 13031 |
Optimist International Member Invitation
Please type or print clearly
Name: ____________________________ Spouse’s Name: _______________________
Were you ever a JOOI Member? Yes No
Are you currently a full-time college student? Yes No
HOME ADDRESS
Street: _________________________________________________________________
City: _________________ State / Province: ____________ Zip/ Postal Code:_________
Home Phone: _____________ Fax: ____________ Email: ______________________
BUSINESS ADDRESS
Firm Name: _____________________________________________________________
Type of Business: ________________________________________________________
Street: _________________________________________________________________
City: _________________ State / Province: ____________ Zip/ Postal Code:_________
Business Phone: ____________________ Email: ______________________________
Fax: ________________________ Business Position or Title: ____________________
May we contact you at work: Yes No
YOUR SIGNATURE INDICATES YOUR ACCEPTANCE OF THIS INVITATION.
Signature: __________________________________________ Date: ______________
Sponsor: ___________________________________________
Optimist Club of _____________________________________
Dates approved by committee: _____________ by Board of Directors: _____________
Individuals who have committed sexual offenses against children may
be denied membership and/or have their membership revoked.
Please complete and give to your local Optimist Club.
www.optimist.org