FORM Skal Membership Rqrd Info 07 by 6llg095


									Skål International: Tampa Bay No. 184              Skål Tampa Bay Prospective Member:
                                                   To complete this form, please enter your information in
                                                   this column. Use the down  arrow or the up  arrow
                                                   keys to move from box to box. You may also use the
                                                   Tab Key. After completion, please save this file and then
In order to propose a new member for the           return it to your Sponsor or to the Club Exec. Secretary:
Tampa Bay Club,        * THE FOLLOWING    or fax to 727-674-4064.
                                                   (The "New Member's Information" entered in this
                                                   column must be copied into the electronic form on the
                                                   NAASC website by the sponsoring Skål member)
                                 Date submitted:
Salutation: * (Mr./Mrs./Ms.)
First Name: *
Middle Initial:
Last Name: *
Subtitle: (Sr/Jr/III)
Place of Birth: * (City / Country)
Date of Birth: * (Month DD, YYYY)                  i.e. December 07, 1941
Spouse’s Name:
Home Address: *
Home City: *
Home State/Province: *
Home Country: *
Home Zip Code: *
Home Phone: * (XXX-XXX-XXXX)
Business Name: *
Title/occupation: *
Activity: * i.e. General Manager-Hotel
Employed in position since: *
(Month DD, YYYY)
Employed with company since: *
(Month DD, YYYY)
Duties: *
Business Address: *
Business City: *
Business State/Province: *
Business Country: *
Business Zip Code: *
Hours per week in above position: *
Other hours if above not full time:
Type of other work
Preferred address for correspondence: *
(Business or Home)
Business Phone: * (XXX-XXX-XXXX)
Business FAX: (XXX-XXX-XXXX)
Cell Phone: (XXX-XXX-XXXX)
Email Address:
 If less than three years in your present
company, include details to cover a minimum of
3 years within travel and tourism. Include
company name(s), position held, activity,
employment period, etc.:
If you have previously been a member of Skål
please state the club(s), Category of membership
(Active, Life, Associate or Local) and the periods
of membership:

Years in Travel / Tourism: *

First name or nick name for Skal badge:
Cell phone #: (XXX-XXX-XXXX)

Additional notes:

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