Membership Form - Waukesha Service Club

Membership Interest Form

Waukesha Service Club

Membership Form

First Name *

Last Name *

Date *

Spouse/S.O. Name (if applicable)

Address *

Address

City

State/Province

Zip/Postal

Phone number(s): Home *

Cell *

E-mail address *

How long have you lived in Waukesha County? *

Current community activities/commitments *

Interests and hobbies *

Professional/career experience *

Sponsors

Sponsor 1

Sponsor 2

How long have sponsor(s) known the membership applicant?

References: If unsponsored, please provide two non-family references, preferably related to community or career experiences, that we may contact.

Name

Relationship

Phone

Name

Relationship

Phone

References will be contacted and asked to complete a Reference form. You will be notified when the reference information has been received, and then you will be invited to a Prospective Member meeting.

If you are human, leave this field blank.

Waukesha Service Club

Sponsors

Gift Shop

Thrift Shop

Gift Shop

Thrift Shop