Renewal Application
Please Print all Information
Name:
________________________________________________________
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)
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: $ ____________ Date:
__________ Check # _________________
Please send completed form to:
PTTB
Revised: 11/22/2008 BC
2009
MEMBER INTERESTS-Renewal
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 |
|
Hobbies-Antique Cars |
70 |
|