Dutchess County Singles, Inc.
P.O. Box 3688
Poughkeepsie, NY 12603
www.DutchessCountySingles.org
Membership Application/Renewal
Please complete this application (either on-line before printing,
if your browser allows; or print it first and then fill in the blanks).
Then sign and mail the application with your check for $15 made out to "DCS"
to the address above.
| Today's date:
Name: Mailing address:
Telephone: Internet:
Age range: Birthday (optional): Marital status: Signature: |
_____________ New membership: ___ Renewal:
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________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Home: (___)_____________ Work: (___)_____________ E-mail: _________________ @ ________________ [ ] Do NOT publish Home page: http:// __________________________ [ ] Do NOT publish [ ] Under 35 [ ] 35-45 [ ] 46-55 [ ] over 55 _____________________ (month/day) [ ] never married [ ] separated [ ] divorced [ ] widowed _____________________________________ |
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| Membership is currently $15 per year for which you receive
a membership card, monthly events newsletters, discounts at dances
and free participation in certain Club events.
DCS needs your help. A wonderful way to meet people is to lead, or help lead, an event. We want to include many types of events in our calendar. If you would like to help our organziation grow and fulfill the needs of single people in our area, please check the activities you would bewilling to help run:
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Membership Applicaiton |
Updated: April 14, 2007 |