Prime Timers Tampa Bay

2009-NEW Member Application Form

( You Must Complete Both Sides and Sign Page Two )

 

 

Prime Timers Tampa Bay is a noncommercial, nonsectarian organization open to all Gay and bi-sexual men over 30 and their admirers who subscribe to our purpose of socialization and fellowship.

 

I wish to Join Prime Timers of Tampa Bay.

 

(Please Print all Information Clearly)

 

Name: _____________________________________________    DOB - M_____ D_____

 

Address: ________________________________________________________________

 

City: ___________________________________State: ____ Zip: ____________________

                                                                                                                                    ( 9-Digit Zip Code )

Phone: __________________________

                       ( 10-Digit Phone Number )

 

E-Mail: ____________________________________________

 

As an active PTTB Member, I will volunteer to work in the following areas:

(Please circle all that apply)

 

Board Member - Communication - Web site - Host Events - Special Projects

 

My Interest's Include: (Please “X” all that apply on page 2 of this application)

 

Prime Timers Tampa Bay does not tolerate discrimination based on color, belief or non belief, national origin, or disability. Any member who speaks or acts in a manner contrary to this policy, may have his membership revoked. Submission of this application affirms your agreement of these policies.

 

 

 

Calendar year Dues: (Jan 1st - Dec 31st)

$20.00 per person for email Newsletter

$30.00 per person for USPS delivery of the Newsletter

 

 

Paid $ __________ Check #:______________  Date: ____________

 

 

Please send completed form and check to:

 

PTTB

PO Box 15582

St. Petersburg, FL 33733-5582

Rev 06/05/2009 BC

 

2009 MEMBER INTERESTS-New Member

 

I am interested in contacting and being contacted by fellow PTTB members who have the same interests as I do.

 

NOTE:  Please put an “X” mark to the left of all the activities in which you are interested.  We would like to get those interested in the various activities together in order to enjoy the activity as a group. 

 

#

X

PUT AN “X” IN BOX ON LEFT

#

X

PUT AN “X” IN BOX ON LEFT

1

 

Antiques

39

 

Literature-Best Sellers

2

 

Art-Ceramics

40

 

Literature-Book Exchange

3

 

Art-Painting

41

 

Literature-Book Reviews

4

 

Art-Sculpture

42

 

Museums-Art

5

 

Art-Stained Glass

43

 

Museums-History

6

 

Beach

44

 

Music-Blues

7

 

Camping

45

 

Music-Choral Concerts

8

 

Drag Shows

46

 

Music-Country

9

 

Exotic-Naturist Beaches

47

 

Music-Jazz

10

 

Exotic-Naturist Parties

48

 

Music-Musical Theater

11

 

Exotic-One on One Encounters

49

 

Music-Opera

12

 

Flea Markets

50

 

Music-Pop Concerts

13

 

Food-Brunch

51

 

Music-Rock

14

 

Food-Fine Dining

52

 

Music-Symphony

15

 

Food-Koffee Klatches

53

 

Parks-Busch Gardens

16

 

Food-Luncheons

54

 

Parks-Disney

17

 

Food-Picnics

55

 

Parks-Homosassa

18

 

Games-Board Games

56

 

Parks-Sea World

19

 

Games Card-Bridge

57

 

Sports Spectator-Baseball

20

 

Games Card-Canasta

58

 

Sports Spectator -Basketball

21

 

Games-Chess

59

 

Sports-Boating

22

 

Games-Dominos

60

 

Sports-Fishing

23

 

Games Card-Golf

61

 

Sports Spectator -Football

24

 

Games Card-Hand & Foot

62

 

Sports-Golf

25

 

Games Card-Hearts

63

 

Sports Spectator -Hockey

26

 

Games Card-Pinochle

64

 

Sports-Swimming

27

 

Games Card-Pitch

65

 

Sports-Tennis

28

 

Games Card-Poker

66

 

Sports Spectator -Wrestling

29

 

Games Card-Uno

67

 

Theatre-Gay Porn Movie Nights

30

 

Gay Bars

68

 

Theatre-Gay Themed Movie Nights

31

 

Hiking

69

 

Theatre-Live Theater

32

 

Hobbies-Antique Cars

70

 

Trips-Camp David

33

 

Hobbies-Ceramics

71

 

Trips-Cruise Ships

34

 

Hobbies-Cooking

72

 

Trips-Day trips

35

 

Hobbies-Gardening

73

 

Trips-Overnight Trips

36

 

Hobbies-Genealogy

74

 

Trips-Sawmill Campground

37

 

Hobbies-Photography

75

 

Walking

38

 

Hobbies-Woodworking

76

 

Zoos

 

Put an “X” here _____ if you have no interests and don’t want to be contacted.

 

I certify that I am at least 21 years of age.

I agree to uphold and abide by the Tampa Bay Prime Timers by-laws.

 

I, and any guest(s) of mine agree to absolve Tampa Bay Prime Timers, its Board of Directors and all other members of any liability due to my (our) participation in Tampa Bay Prime Timers group activities.

 

 

Signature: ________________________________________              Date:  _________________________

 

Rev: 06/05/2009 BC