Membership Application
Initiation Fee: $20.00
Joining between May
1 and December 31 pay for one full year: $100.00
Joining between January
1 and April 1 pay for one-half year: $50.00
Student or Retired:
$50.00
Name_______________________________
Phone___________________________________
Title________________________________
Fax_____________________________________
Company Name ______________________
E-Mail___________________________________
Address_____________________________
City & Zip________________________________
Product/Service____________________________________________________
A check (payable
to Propeller Club) in the amount of $__________ is enclosed.
Or please charge
my credit card as listed. _______M/C _______Visa
Name on card ________________________________________________________________
Card No. _________________________
Exp. Date __________________________________
Signature_________________________
Date_______________________________________
Signature of Applicant_________________________________________________________
Two references, members
of the Club____________________/________________________
Check committee Interest:
___Education ___Golf ___Membership __Legislative
___Programs/Awards ___Reception ___Seafood Feast
Print this form and
mail with check to the address listed below.
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