Current Date: __________________________ 

Name: ________________________________________________________________________ 

Address: ________________________________________________________________________ 

Home Phone: _________________________ Cell Phone: ________________________________ 

E-mail: ________________________________________________________________________ 

Prior City and State of Residence (if new to Columbia) ____________________________________ 

Birthday Month __________________ Spouse/Significant Other’s Name _____________________ 

Please check one: 

___________ Newsletter e-mailed $20 

___________ Newsletter via postal services $30 

Please complete the form and return with your check to: 

Columbia Newcomers Club, PO Box 30602, Columbia, MO 65203 

Please take a moment to let us know what special interest groups you would like to learn more 

about by placing a check next to the group name. 

_____ Book Club _____ Guys and Dolls Happy Hour _____ Walking 

_____ Bridge _____ Hand and Foot _____ Wine Tasting 

_____ Bunco _____ Lunch Bunch _____ Happy Hour Wine Tasting 

_____ Canasta _____ Needle Talk _____Girls Night Out

_____ Coffee _____ Movie 

_____ Opera _____ Scrabble