Single Gourmet DFW Membership ApplicationAll information is for the exclusive use of Single Gourmet DFW and will NOT be sold. Annual membership: $195 (runs 13 months). Circle your title and gender: Ms. Miss Mr. Dr. Gender: M F Name: ___________________First ____________________Last _______________Nickname Address:________________________________________________________________ City:_______________________________ State: _________________ ZIP:_____________ Daytime Phone:_______________ Cell Phone: :________________ Night phone:________________ e-mail:____________________________________________________(e-mail
required for membership) Age Range (30 - 69) D.O.B:___________ ________ ____________ (Mo/Day/Year used for seating purposes only) Profession:____________________________ Employer:_______________________________ What is your motivation for joining Single Gourmet DFW?________________________________ Circle which of these events interest you: Wine Tastings Cooking Classes Travel Culinary Tours Dancing Three hobbies or interests:_________________________________________________ Circle one: How
did you hear about us? Website Friend
Pegasus News 8 at 8 Newspaper Brochure Other Circle one: May we use your photo on our website? Yes No VISA
/ MasterCard / Discover / AMEX # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Cardholder's Name_______________________________________________________________ Fax
to 972-250-1840 or mail with credit/debit card info to:
___ Only credit and debit cards accepted for membership and event registration ___ Our guarantee: Join and attend at least two events during the first 60 days. If you feel we're not a good fit, |