Take advantage of our "Electronic Forms" and send us your information without having to download and mail our questionnaire and membership form using regular mail.
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Your Name: (Last, First, Middle optional)
Spouse Name
Dept/position
Address
Home Phone
Cell Phone
Are you employed?
Resident-Fellow Questionnaire
You are a:
Name
Department
Spouse's E mail
Address
Phone
Marital Status
If single, please skip until the last question.
Name of Spouse
Spouse's Phone
Occupation
Employed?
If Yes:
Children?
If Yes: How many?
Names, Ages
& Grades
I would find information on the following to be useful (check as many as apply):
Areas of Interest/Hobbies/Leisure Activities (1-3):
Would you be interested in receiving information about PALMS and their activities?
LAST QUESTION:
Please suggest any way(s) that an organization like PALMS could serve you.
E mail
If YES, business/position:
Areas of Interest/Hobbies (List 1-3):
Husband’s Favorite Leisure Activities (List 1-3):
Current Volunteer/Community Service Activities:
Performing Arts Talent (for possible future event):
Favorite Restaurants:
Casual:
Special:
Membership Form
