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MEMBERSHIP APPLICATION 2010-11
www.barringtonilnewcomers.org
New Member _______ Renewing Member _______
General Information (required, please print)
Name ________________________________________________________DOB_________
Month/day
Address _____________________________________________________________________
Home Phone ____________________________ Cell_________________________________
E-Mail Address _______________________________________________________________
Relocated From _______________________________________________________________
Spouse’s Name _______________________________________________________________
Child(ren)'s Age(s)& schools attending_____________________________________________
Programs and Activities (please check areas of interest)
Daytime/Weekday Evening/Weekend
□ Almost Gourmet □ Bunco
□ Book Club □ Book Club
□ Gardeing
□ Family Fun □ Weekend Gourmet
□ Bowling □ Wine Tasting
□ Golf
□ Coffee & Conversation
□ Bridge
□ Game Day
□ Adventure Club
• Please list any suggestions you have for a new activity or program.
• Please list any skills or hobbies you’d be willing to demonstrate as a small group activity.
Please complete this form and return with your $30 membership check made payable to: Barrington Newcomers &
Neighbors
Mail to: Cathy Sporleder, 20 Lakeside Lane, N. Barrington, IL 60010
(847) 277-1533; email: Spor4@aol.com
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