2010/2011 NEWCOMERS CLUB MEMBERSHIP RENEWAL
                                           Expires August 31, 2011

Please print this form and complete by hand, then mail it with your $25 check (payable to Newcomers) to:
          Newcomers Club Renewal, c/o Erin Beltz, 14355 Golfview Drive, Eden Prairie, MN 55346

NAME _________________________________________________________________

SIGNIFICANT OTHER’S NAME (if any)________________________________________

ADDRESS______________________________________________________________

CITY & ZIP_____________________________________________________________

PHONE (            )_____________________  CELL (           )_____________________

E-MAIL ADDRESS  _______________________________________________________   

PREFERRED VOICE CONTACT:   Phone___   Cell___    BIRTHDATE _____/_____ (mm/dd)

ACTIVITIES YOU ARE INTERESTED IN:

            ___Book Club                                     Dining Groups:
            ___Bowling                                             ___Dining Out
            ___Bridge                                               ___
            ___Bunko                                                ___Large Group Dining In
            ___Chick Flicks                                        ___Welcome Coffee
            ___Guthrie Matinee
            ___Happy Golf                                    ___Civic/Philanthropy
            ___Mah Jongg
            ___Mainly for Men                              Other_________________________________
            ___Rubber Stamping / Scrapbooking   
            ___Social Events (mainly evening & weekend)
            ___Social Meetings / Monthly Luncheon              

Please list any talent, skill, or interest that you would be willing to share with the group:

_____________________________________________________________________________

Please suggest speakers or topics for monthly luncheon:

_____________________________________________________________________________