SWAN Membership 2017-18
Please complete all questions, for any question that doesn't apply, please type in "N/A". The answers you provide will be used to print the directory and to do the monthly mailings. We want to be sure that all information is correct and up-to-date.

NOTE: Any information you provide will be used in the SWAN directory, mailings, etc. and available only to SWAN members.

If you have any questions contact Kathy Fisher, VP Membership at (952)941-5303.

First Name *
Your answer
Last Name *
Your answer
Spouse's / Significant Other Name
Your answer
Birthday Month (Number) *
Your answer
Birthday Day *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Primary Phone Number *
Indicate if it's a cell or home phone number by typing a (c) or (h) after the number. i.e. 612-555-1212 (c), for a cell phone.
Your answer
Secondary Phone (if applicable)
Your answer
Email: *
Note: Required for members to receive electronic newsletters.
Your answer
Membership Status: Renewing *
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