Membership Application

Membership Application (Full)

First Name

Last Name

Phone Number (cell)

Phone Number (home)

Address

Address Line 1

City

State

Zip Code

Emergency Contact Name

Emergency Contact Phone

Spouse's Name (if married)

Do you have children?

Yes

How long have you lived in Miami?

Do you have pets?

Yes

What are your hobbies and interests?

Current or former occupation

Summary of your professional background

Please list other organizations and/or boards you have or are serving on

Volunteer positions held

Skills and Talents

Date of Meetings Attended/Events volunteered at [3]

Birthday Month

Birthday Day

Sponsor #1 Name

Sponsor #2 Name

Sponsors are current members of the Woman’s Club and will need to provide a letter of recommendation.

Area of Interest/ skills

Headshot Photo of You (JPG or PNG)

Choose Photo

Active or Associate Membership?

Active

Associate

Comments (optional)