Lackland Spouses' Club Membership Application 2019-2020
Email address *
Name *
Your answer
I am a new member of the LSC this year:
Primary Phone: *
Your answer
Alternate Phone:
Your answer
Current Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
ZIP Code: *
Your answer
Birthday (MM/DD):
MM
/
DD
Application for membership shall be open to any Active/Retiree spouses adult dependent that holds a DOD Card and has base privilege. Members are voting members. Membership is granted after completion and receipt of a membership application and payment of annual dues. Honorary Members are widows of service members and do not have to pay dues, but have no voting rights.
Affiliation: *
SPOUSE Name *
Your answer
SPOUSE Rank *
Your answer
Duty Organization (If Active Duty) *
Your answer
I am interested in Serving on the LSC Board as a Chair/Co-Chair: *
I am interested in serving on a committee (Scholarship, Charitable, Thrift Shop): *
I give permission for my name, address, email, phone numbers(s), and birthday to be published in the LSC Directory. *
I give permission for my photo to be used in any LSC publication including but not limited to the Bluebonnet Gazette, email updates, or on the LSC website or LSC Facebook page. *
I understand that per LSC By-Laws, if I RSVP 'Yes' to a function that has a cost, I am responsible for the cost (and that of my guest) if I am unable to attend unless I cancel by the RSVP date. *
I understand that as a member, we are jointly liable for the obligations of the LSC and per the Constitution in accordance with AFI 34-223. *
DUES: $40 for active duty /retiree spouses and $0 for widows who wish not to have voting rights. (dues for members joining after Jan 1 is $20)
Payment of Dues *
Signature *
Your answer
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service