Optimist Membership Application

Stoughton Optimist Club
	Bringing out the Best in Kids

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Optimist Membership Application

Thank you for your interest in joining the Stoughton Optimist Club. The Stoughton Optimist Club is a group of volunteers dedicated to working with and helping the youth in the Stoughton area. Please complete the following information and we will contact you as soon as we review your application.

Required Information

First Name:	Last Name:
E-Mail:	Home Phone:

Additional Information


Were you ever a JOOI Member?	Yes No

Are you currently a full-time college student?	Yes No

Additional Information

Address Main:

Address Cont'd:

City:

State:

Zip:

Fax:

Cell Phone:

Business Address

Firm Name:	Type Of Business:
Business Position or Title:	E-Mail:
Address Main:	Address Cont'd:

City:

State:

Zip:

Business Fax:

Business Phone:

May we contact you at work:

Yes No

Sponsor

Did someone recommend you to join our organization? If so, please let us know which club and club member recommended you?

Optimist Club Of:

Sponsor:

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