The Illinois Club of Tellico Village Close Window Membership Application |
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The annual Illinois Club dues is renewable January 1st of each year. |
Make Check Payable To:
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This Section is for Club Use: Dues Paid (yes/no): ____________ Date Received: ________________ Date Entered: _________________ Entered By: __________________ |
$ 5 per Person -or- $10 per Family |
Mail Form and Check to:
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| Welcome to the TV Illinois Club, one of the most active clubs in Tellico Village! Please complete all of the information below, make your check out and mail them to the club address (above/center). Once your application is processed, you will receive a confirmation by email so be sure to print your email address clearly. Thank you, we look forward to seeing you soon. | ||
| First and Last Names: | ___________________________________________________________________________ | ||
| Street Address: | ___________________________________________________________________________ | ||
| City: ___________________________________ | ST: ____________ | ZIP: _________ | |
| Phone: | Home: (_____) ___________________________ | ||
| Cell: __(_____) ___________________________ | |||
| Email Address: | ___________________________________________________________________________ | ||
(Club activities are broadcast primarily via Email, Club Website, Channel 3 TV and local newspapers.) |
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| Would you be willing to help with an activity? _______________________ | |||
| Below, please list any suggestions for club activities ( you can review current and past activities on our website.) | |||
| ___________________________________________________________________________ | |||
| ___________________________________________________________________________ | |||
| ___________________________________________________________________________ | |||
| Form Revised: 12/08 | |||