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ASU Women's Club Membership Form *Please review ALL 13 question blocks
This information is used to know how to contact you and what your interests are.
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* Indicates required question
CONE FLOWER AND BUTTERFLY - (please scroll down for questions)
Last Name, First Name
*
Your answer
Home Phone - please type: (xxx)xxx-xxxx (H)
Your answer
Office Phone - Please type: (xxx)xxx-xxxx (O)
Your answer
Cell Phone: this is required if no home # (xxx)xxx-xxxx (C)
Your answer
Email address:
*
Your answer
Dept. if ASU Employee or state 'Student'.
*
Your answer
If membership is through affiliate, provide NAME and relationship (i.e. spouse; partner)
*
Your answer
Street Address, Apt., etc.
*
Your answer
City, State, Zip
*
Your answer
If membership is through affiliate, what is their Dept?
*
Your answer
Select Club Groups you are Interested in:
Book Club DayTime
Book Club Night Time
Daytrippers
Hiking
Food Talk
Hand & Foot (Hand/Knee/Foot) - Friday mornings
Lunchbunch - Wednesday - 1x per month
Chinese Mahjongg Monday evening 2x per month
Movie Appreciation
Needlework
Student Coffees / Reading Day
Further involvement? Please check any that you are interested in.
Be a group leader?
Officer in the Club?
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