Lakeside Pride Membership Form 2016-2017
Please fill out this form with updated contact and demographic information!
Last Name
Your answer
First Name
Your answer
Email
Your answer
Phone
Please write your phone number in the form: XXX-XXX-XXXX
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Chicago Neighborhood
If applicable
Your answer
What is your Birthday (month and day)?
MM
/
DD
Occupation
Your answer
Employer
Your answer
Special Skills/Hobbies
Your answer
Emergency Contact Last Name
Your answer
Emergency Contact First Name
Your answer
Emergency Contact Email
Your answer
Emergency Contact Phone
Please write their phone number in the form: XXX-XXX-XXXX
Your answer
What ensemble(s) are you interested in joining in the 2016-2017 season?
Required
What instrument(s) do you play?
Required
How did you learn about Lakeside Pride?
Required
Which dues options will you be opting for the 2016-2017 season?
Note that our financial year is from September 1, 2016 - August 31, 2017. Alternate amounts and payment plans will be kept confidential between the member, the secretary, and the member resources chair. Alternate amounts and payment plans will also have no bearing on the number of ensembles one may join.
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