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Membership Application


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 65205 

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 Clubs  _____ Guys and Dolls Happy Hour 

_____ Hand and Foot  _____ Wine Tasting  ----- Walking

_____ Lunch Bunch  _____ Happy Hour Wine Tasting 

_____ Canasta  _____ Needle Talk  _____Girls Night Out

_____ Coffee   ______ Monthly Luncheon w/ Program

_____ Opera  _____ Scrabble   _____ Movie