NEW Member Application Form
I wish to Join Prime Timers of Tampa Bay.
(Please Print all Information Clearly)
Name:
_____________________________________________
DOB - M_____ D_____
Address:
________________________________________________________________
City:
( 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)
Signature: ___________________________________________
Date: ________________
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 #:______________
Please send completed form and check to:
PTTB
PRT 11/22/2008 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.
(Please Print
Clearly)
YOUR NAME:
______________________________________________________
CONTACT
INFO Phone:
_______________________ Email:
______________________________________
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 |
|
|
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 |
|
|
|
16 |
|
Food-Luncheons |
54 |
|
Parks-Disney |
|
17 |
|
Food-Picnics |
55 |
|
Parks-Homosassa |
|
18 |
|
Games-Board Games |
56 |
|
Parks-Sea World |
|
19 |
|
Games-Bridge |
57 |
|
Sports-Baseball |
|
20 |
|
Games-Canasta |
58 |
|
Sports-Basketball |
|
21 |
|
Games-Chess |
59 |
|
Sports-Boating |
|
22 |
|
Games-Dominos |
60 |
|
Sports-Fishing |
|
23 |
|
Games-Golf |
61 |
|
Sports-Football |
|
24 |
|
Games-Hand & Foot |
62 |
|
Sports-Golf |
|
25 |
|
Games-Hearts |
63 |
|
Sports-Hockey |
|
26 |
|
Games-Pinochle |
64 |
|
Sports-Swimming |
|
27 |
|
Games-Pitch |
65 |
|
Sports-Tennis |
|
28 |
|
Games-Poker |
66 |
|
Sports-Wrestling |
|
29 |
|
Games-Uno |
67 |
|
Theatre-Gay Porn Movie Nights |
|
30 |
|
|
68 |
|
Theatre-Gay Themed Movie Nights |
|
31 |
|
Hiking |
69 |
|
Theatre-Live Theater |
|
32 |