Chestertown Lions Membership Application

Name:

Mailing Address:

Date of Birth:

Email:

*Home Phone:

Work Phone:

*Cell Phone:

Occupation:

Name of Spouse / Partner:

*Sponsor:

Date of Application:

Programs/Activities of Interest:
Bay to Bay Bike RideChicken BBQAdopt a HighwayChristmas Basket ProgramShotgun Raffle SalesPeace Poster ContestVision Screening for KidsTransportation Program (eye appointments)Christmas Flowers / Gifts for Nursing HomesHomeports Health FairFood PantryLions helping with 4H FairHalloween ParadeDiabetes AwarenessOther
If Other, Please Specify:

Additional Comments:

Membership dues will be billed quarterly. The cost is $31.00 per quarter plus the cost of meals for the dinner meetings you attend. For regular dinner meetings the cost is $22.00 per meal. For special dinners (Christmas and Valentines) the price will be slightly higher. You will be receiving an email from the Lions Club Secretary a week before each meeting to RSVP. We have to take reservations so the Country Club has an accurate count for meals.
Welcome ! Great to have you as a member of our club!
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