Midland Newcomers
Membership Application
The following information helps us compile a complete directory of our members.
 Please print this form and return it along with your payment for dues
to the treasurer or to:
Midland Newcomers Club
P.O. Box 2793
Midland, Mi.  48641-2793
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Board use:
2006/07        Date: ____________         Ck. no. ____________         dir_____        ml_____
2007/08        Date: ____________         Ck. no. ____________         dir_____        ml_____
2008/09        Date: ____________         Ck. no. ____________         dir_____        ml_____
2009/10        Date: ____________         Ck. no. ____________         dir_____        ml_____
2010/11        Date: ____________         Ck. no. ____________         dir_____        ml_____
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Name:
Address:
City:
 State:
 Zip:
Telephone:
E-mail Address:
Your birth date (month/day):
Your anniversary (month/day):
Spouse's name:
Children living at home:
Name
 Birth date (month/year)
Baby-sits?
When did you move to Midland?
Where did you move from?
How did you hear about us?