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__ '''I have signed the Liability Waiver.''' |
__ '''I have signed the Liability Waiver.''' |
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'''Applicant Signature:''' ____________________________________ '''Date:''' ____________ |
'''Applicant Signature:''' ____________________________________ '''Date:''' ____________ |
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| − | __ '''Applicant has been approved by present members.''' |
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'''Officer Signature:''' _______________________________________ '''Date:''' ____________ |
'''Officer Signature:''' _______________________________________ '''Date:''' ____________ |
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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: ____________
Officer Signature: _______________________________________ Date: ____________
Based on the Hive 13 Membership Application