Membership Application

Application for Membership in
Soroptimist International of Long Beach

Before completing this application form,
please review Responsibilities of Membership

Please complete the following form to apply for membership.

Today's Date

Do you live or work in the area of greater Long Beach, California? Yes No

How did you learn about Soroptimist International of Long Beach? Select any of the following options that apply:

Newspaper	Friend
Employer	Women Who Make A Difference Awards
Soroptimist House	Internet
Other If you choose "Other", please tell us where:

Please tell us about yourself by answering the following questions.

Name

Home Address:

City

State

Zip

Home Phone

Gender

Female Male

Month & Day of Birth

Year of Birth (optional)

Name of Significant Other (As you would like to have it listed in our roster)

Employer

Your Title

Work Address:

City

State

Zip

Work Phone

Work
Fax

Use the box below to describe your business and responsibilities:

What else would you like us to know about you? (Such as your hobbies, interests, etc. Use box below for your answer).

Why are you interested in joining Soroptimist International of Long Beach?
Select any of the following options that apply:

networking	service projects
enhancing status of women	international scope
making new friends	volunteer opportunity
quality of programs	learn new skills
leadership development	become active in community

Application for Membership in Soroptimist International of Long Beach

Print and mail to: Recruitment Chair Soroptimist International of Long Beach P.O. Box 15064, Long Beach, CA 90815-0064

Application for Membership in
Soroptimist International of Long Beach

Print and mail to:
Recruitment Chair
Soroptimist International of Long Beach
P.O. Box 15064, Long Beach, CA 90815-0064