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HomeProspective Member Form

To The Membership and Classification Committee, Zonta Club of Parker County: I would like to submit the following name for possible membership:

Sponsoring Member:___________________________ Date:____________________________

Name_______________________________________ Date of Birth______________________

Mailing Address__________________________City:____________ST__________Zip________

Home Phone______________________________         Cell Number_______________________

Home Email____________________________________________________________________

Business or Profession___________________________________________________________

Business Address_________________________City____________ST__________Zip_________

Business Phone__________________________ Fax____________________________________

Business Email__________________________________________________________________

Location to receive Zonta Mail:               ( ) home or ( ) business

Location to receive Zonta Email:            ( ) home or ( ) business_____________________________

What is the individual’s executive position or title with their business?_____________________

 Does the individual give 50% or more time to the business or profession listed ( ) yes  ( ) no

Other Civic and Club Affiliations:___________________________________________________

Yes I want to become a member of the Zonta Club of Parker County, and subscribe to the objectives of this organization.

Dues:                      $83.00                    Annual membership dues-International and National

                                    $28.00                    District

                                    $15.00                    One-time membership fee

                                    $40.00                    Local Dues

                                    166.00

Optional               $262.00 to include annual lunch fees $96.00 for 8 meetings @ $12.00 each

Please check the committees in which you would like to serve. ( ) Membership & Classification,

( ) Advocacy, ( ) Status Of Women Service & United Nations, ( ) Attendance & Fellowship, 

( ) Public Relations and Communication Committee, ( ) Ways and Means Committee, 

( ) Scholarship Committee, and ( ) Finance. 

 

Applicants Signature:___________________________________Date:_____________________

                                              Mail form and check to Zonta Club of Parker County

Zonta International is a leading global organization of professionals empowering women worldwide through service and advocacy

 

P. O. Box 2095                      Weatherford, Texas 76086               www.zontaparkercounty.org