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Application for Charter Membership |
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| Print page then fill in the
information and bring in or mail to: |
The
Link 1300 Spartan Drive Connersville, IN 47331 |
| Name | ||||||||||
| Address | ||||||||||
| City | State | Zip Code | ||||||||
| Sex (circle) M / F | Email Address | |||||||||
| Member Status | _____New | _____Dual | _____Reinstated | _____Transfer from Club | ||||||
| Manuals | _____English | _____Chinese | _____French | _____Spanish | _____Japanese | |||||
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_____Cassette Tape (visually impared)
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| Amount of Dues Paid | Date | |||||||||