LA SOCIETÁ ITALIANA, INC. NEW MEMBER FORM

    (ALL FIELDS WITH AN ASTERISK ARE REQUIRED)

    NEW MEMBER (#1) INFORMATION

    SPOUSE/SIGNIFICANT OTHER (#2) INFORMATION IF JOINT MEMBERSHIP

    CONTACT INFORMATION

    CHILDREN (IF APPLICABLE)

    PLEASE DESCRIBE YOUR EXPECTATIONS FOR THE CLUB

    PLEASE SELECT (X) ANY OF THESE CLUB EVENTS/COMMITTEES TO INDICATE YOUR INTERESTS

    Committee
    #1
    #2
    Membership

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    Checkbox_1
    Publicity

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    Checkbox_2
    Cultural/Heritage

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    Recipe

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    Web Site

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    Event
    #1
    #2
    La Befana

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    Columbus Day

    Checkbox_13


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    Carnevale

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    San Giuseppe

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    Bocce Ball

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    Event
    #1
    #2
    Annual Picnic

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    Italian Cooking

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    Carnevale Raffle

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    Event Photos

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    DUES CALCULATION AND MAILING INSTRUCTION

    1)La Societa Italiana's Fiscal Year begins in September and runs through August of the current year

    2) Annual dues for the Fiscal Year are $60 ($5/mo) per person or $120 ($10/mo) per couple which includes children who live at home

    3) If you are joining after September, please prorate your Current Year Dues as follows:

    a) count the number of remaining months through August

    b) multiplying that number by $5 (if joining as an individual), or $10 if joining as a couple

    c) prepare and remit your check as described below

    i. Please make check payable to "La Societa Italiana, Inc."

    ii. Mail your check and this form for processing to the Membership Chairperson of La Societa Italiana,

    Maureen Colletta, 60 Lakeshore Drive, Berkeley Lake GA 30096

    SIGNATURES (Use Mouse to Sign)