IT'S EASY TO !  

Name:
Address:
Address2:
City:
State:
Zip Code: Is it OK to send mail to this address? Yes No
Work Phone: Is it OK to call this number? Yes No
Home Phone:Is it OK to call this number? Yes No
E-Mail: Is it OK to publish e-mail in Membership Roster? Yes No
Birthday (MM/DD)
Partner's Name (If couple)
Partner's Birthday (MM/DD)

Mail this form with a check or money order, $30.00 for singles or $50.00 for couples, to:

Prime Timers - Houston
P.O. Box 980612
Houston, Texas 77098-0612

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