Membership No.______Admitted as Member:______Do not write in this space Do not write in this space
Must be filled VEREINIGUNG ERZGEBIRGE out completely! ~ Proposal for Passive Membership ~
Email:______
Name:______Phone:______(Please Print Legibly) Address:______
City:______State:______Zip:______
Date of Birth:______Are you a Citizen? r Yes r No ( MONTH / DAY / YEAR ) Place of Birth (City):______State:______Country:______Trade or occupation at present:______Family Information: r Married r Single Name of Spouse:______Spouse Date of Birth: ______Spouse Place of Birth:______( MONTH / DAY / YEAR ) Trade or occupation of spouse:______List first names and birth dates of your children:______Referred by:______References – Are you related to a member? r No r Yes – Name and relationship:______Name of member who first brought you to the club as a guest:______Did you participate in any club activities? r No r Yes – If Yes, please list activities:______What activities are you and your family interested in? Indicate by check (3) r Singing r German Classes r Swimming r AISL (Darts/Shuffleboard/Horseshoes) r Soccer Name of Coach:______What is your family’s knowledge of the German language? r Understand r Read r Write
Are you willing to donate (work) 1 or 2 days a year to the club: Yes______No______Are you willing to participate in club committees to further social and group functions at Vereinigung Erzgebirge: Yes______No______
Date______Signature of Applicant______
I hereby certify that I am acquainted with the candidate having signed this application, that I vouch for his good character and reputation, and, therefore, recommend him for admission to passive membership of the above organization.
Name of Proposer: (Signature) ______Book No.______
(Please Print) ______
Name of Proposer: (Signature) ______Book No.______
(Please Print) ______Both sponsors must be Active Members of Vereinigung Erzgebirge.
Dues: $160.00 Annually / $50.00 Application Fee Payable by cash/check: $210.00 / by CC: $220.00 / venmo@VEClub: $220.00 Return this form via USPS: VE Club, 130 Davisville Road, Warminster, PA 18974 or email to: [email protected]