Canton Newcomers Club

Membership Form

 The aim of the Canton Newcomers Club is to extend a friendly and neighborly helping hand to you by introducing you to other members of the Canton community, so you may share your interests and hobbies.

 Date:___________________________

Name:_______________________________________________

Spouse’s Name:________________________________________

Home Address:________________________________________

Zip Code:________________Phone:_______________________

Birthdate (MM/DD):_________ Email:_____________________

Children’s names and ages: _______________________________

____________________________________________________

Current and/or Prior Occupation:__________________________

____________________________________________________

Please check if you are a new member:  □

 I arrived in Canton in (month/year)______ from______________

Special interests or hobbies:  ____________________________________________________
Please send check and completed form to: 

Canton Newcomers

P.O. Box 825

Canton, CT 06019

 

For Club Directory:

If you would like your name listed differently than the above information, please indicate so here:

Name:_______________________________________________

Mailing Address:_______________________________________

____________________________________________________

Email:_______________________________________________

 
Dues: $25 per year.  Cash or check made payable to “Canton Newcomers Club”

For membership only:

Date paid: __________Date forwarded to Treasurer:__________

Date sent to Corresponding Secretary:__________     

Date submitted to Newsletter:_________________

**Please submit form by the 20th of the month to receive the following month’s newsletter**

Membership Form

Canton Newcomers Club