EWC New Member Registration 2017 - 2018

Email address *
Thank you for joining Eastside Welcome Club!
Our new club year starts on July 1, 2017 and ends June 30, 2018. Membership dues are $40 for the club year.

Please complete the information on the following 2 screens and click the "Submit" button upon completion. Confirmation of your registration will be emailed to you.

First Name (as you would like it entered in the membership directory) *
Your answer
Last Name (as you would like it entered in the membership directory) *
Your answer
Cell Phone Number (xxx.xxx.xxxx)
Your answer
Other Phone number, on which you wish members to phone you. (xxx.xxx.xxxx)
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Spouse/Partner's Name
Your answer
Birthdate (MM/DD) if you wish to be acknowledged in the newsletter.
Your answer
Children and Birthyears (please enter Name BY, Name BY ex Sean 04 since Sean was born in 2004)
Your answer
How did you hear about EWC?
Your answer
Please tell us a little about yourself.
This information will be used to write a newsletter article welcoming you to EWC and introducing you to other members.
Your answer
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