Membership Application

KYLE AREA SENIOR ZONE, INC. (revised 12/2013)

APPLICATION FOR MEMBERSHIP

P.O. BOX 204 – 101 S. BURLESON

KYLE, TX 78640 – PHONE (907-360-8435)

PLEASE PRINT CLEARLY

NAME/NAMES___________________________________________________________

ADDRESS_________________________________CITY/ZIP________________________

PHONE_______________ EMAIL_____________________________________________

DATE OF BIRTH (Month & Day only) __________________________________________

I HAVE SPECIAL INTERESTS, HOBBIES OR TALENTS THAT I WOULD LIKE TO SHARE WITH OTHER SENIORS: __________________________________________________________

ONE TIME MEMBERSHIP DUES:  $9.00 PER PERSON

CORPORATE OR PERSONAL SPONSORSHIP $100.00

(Sponsorships are available to seniors who may find it a hardship to pay the dues.  Please note your request or see a Board Member.  Your request will be kept confidential.)

PLEASE CHECK A COMMITTEE/S YOU WOULD LIKE TO SERVE ON:

CULINARY CREATORS (Planning meals, holiday events, birthdays) ______ direct lender payday loans

PROGRAMS/ENTERTAINMENT__________________________________

PROPERTY & INTERIOR DECORATING____________________________

PUBLICITY ________________________________________

FUNDRAISING/FINANCE_______________________________________

NOMINATING_______________________________________________

CARE COMMITTEE (sending cards to sick & shut-in members) _________

MEMBERSHIP_______________________________________________

PHOTOGRAPHY______________________________________________

THIS IS YOUR ORGANIZATION. HELP ON ANY COMMITTEE AND/OR ACTIVITY HELPS MAKE US BETTER. WE ALWAYS ENCOURAGE YOUR PARTICIPATION.

Members who wish to rent the hall must be a member for 6 months before they can rent the hall thru KASZ

Book_____  Badge______ $______