The Happy Wanderers Walking Club ● P.O. Box 290153 ● Port Orange, Florida 32129

(Please complete form before printing)

MEMBERSHIP APPLICATION


Date:   
Renewal
 
 1st Year ONLY includes New Walker Packet ($5.00 Value)
 
New Member
New Member includes ONE
New Walker packet.
New Member includes TWO
New Walker packets.
Phone:
How did you hear about us? (circle)

Library   Newspaper   YMCA   Friend/Family   Natural Awakenings   Website

Other: ______________________________________________________  

Do you have a computer   Yes __    No __    Do you use Facebook?    Yes __    No __    Are you a AVA member?   Yes __   No __

Do you wish to share your contact information with fellow club members?   Yes __   No __

Please make checks payable to:
The Happy Wanderers Walking Club, Inc.
P. O. Box 290153
Port Orange, Florida 32129 

FOR CLUB USE ONLY
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New Walker Packet(s) provided: _____YES  ______NO
Check #_______ Amount $__________     Cash $_________
This is your receipt of payment in the amount of $____________ in the form of cash or check (circle one) for membership in the Happy Wanderers Walking Club received on __________________________. Membership runs from Jan-Dec. each year. We value your membership and hope to see you often.