The Illinois Club of Tellico Village                  Close Window       

Membership Application

The annual Illinois Club dues is renewable January 1st of each year.

Make Check Payable To:

Tellico Village Illinois Club

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:

          The Illinois Club
P.O. Box 52
Loudon,TN 37774
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.)
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