Dayton Diode Wiki
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'''Address:''' _________________________________________
 
'''Address:''' _________________________________________
   
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_________________________________________________
   
 
'''Phone number:''' _________________________
 
'''Phone number:''' _________________________
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'''Officer Signature:''' _______________________________________ '''Date:''' ____________
 
'''Officer Signature:''' _______________________________________ '''Date:''' ____________
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Based on the [http://wiki.hive13.org/How_To_Become_A_Member Hive 13 Membership Application]
 
[[Category:Membership]]
 
[[Category:Membership]]

Revision as of 13:49, 2 November 2010

Name: ___________________________________________

Address: _________________________________________

_________________________________________________

_________________________________________________

Phone number: _________________________

Email address: ___________________________________

__ I have read and agreed to abide by the Dayton Diode Charter.

__ I have read and agreed to abide by the Membership Agreement.

__ I have signed the Liability Waiver.

Applicant Signature: ____________________________________ Date: ____________

__ Applicant has been approved by present members.

Officer Signature: _______________________________________ Date: ____________


Based on the Hive 13 Membership Application