MENINAK CLUB NEW MEMBER PROPOSAL FORM

The membership of this club shall consist of persons of good character, good community standing and good business or professional reputation engaged as proprietor, partner, corporate officer or manager of any worthy and recognized business or profession or holding an important position in an executive capacity with discretionary authority in any worthy and recognized business or profession.

NAME__________________________________________NICKNAME_______________

TITLE________________________________CLASSIFICATION____________________

BUSINESS______________________________________________________________

ADDRESS________________________________________________ZIP____________

PHONE________________FAX__________________E-MAIL______________________

SPOUSE______________________________CHILDREN_________________________

HOME ADDRESS_________________________________________ZIP_____________

HOME PHONE___________________________________________________________

BIRTHDATE (mm/dd/yy)____________________________________________________

BUSINESS ASSOCIATIONS_________________________________________________

SOCIAL ASSOCIATIONS___________________________________________________

(To be filled out by a Meninak)

I certify that the proposed member is not a member of another civic club and that I have known the proposed member and/or business connections for ______________years.

PROPOSER_______________________________________________DATE___________

ENDORSER (1)_________________________ENDORSER (2)______________________