Name(s) M.,Mme,Mlle___________________________________________________________
Address ______________________________________________________________________
City__________________ Zip+4 ______________ E-Mail 1_____________________
Phone (__________ )
_________________________ E-Mail 2
__________________
Membership dues for the '11-'12 season:. . .Individual $50 ; Couple $75. . . . Dues _________
(if joining after Jan.28, dues are reduced to $25/$38 for Feb.'12 thru Aug,'12)
Cours de français (Intermediate/Advanced dual level) starting Th.Oct.6.
. . . Enrollment: 8 students minimum& 14 students maximum. . $154. . . . Class fee ________
If you join by Oct.1 and volunteer to contribute
baked goods towards Tea at one of our future programs............. please subtract $5 (_______)
& Mme. Joan Lindsey will contact you to confirm the date/details of your food contribution.
SUBTOTAL: $_________
Donation: Your added support of
our club's programs and CENTENNIAL events, add that amount here. . . .Donation... $_________
(Your thank-you gift for donations of $100 or more: a sterling silver pin, exclusively
designed for AF du NS. TieTac -or- WomansBroach/pendant(Circle preference.)
........................................................Your TOTAL (enclosed)$_______________
......Please make your check payable to: "Alliance Française du North Shore".
Return form and payment to: M. Robert Bonges,Treasurer AF du NS
1221 Forest Ave,Evanston, IL 60202-1409
Your areas of interest? The success of our francophone offerings relies on the active
involvement of our members. Please indicate the activities you might pursue:
_____Publicity efforts ____Web site ___post-lecture Tea&Refreshments
_____Newsletter ____Ciné Club ___Cercle de lecture w/MmeWhiting
___Memb. Directory ____Photography ___Café Littéraire w/MmeRano
_____Welcoming attendees ____Videography ___ Cercle des contes
____ Centennial Celebrations ___ InfoTable@farmer'sMarkets
____ Other:
_______________________________________________
(Cercle de Lecture and Café Littéraire are for advanced fluency or native readers&speakers.)
SONDAGE: Tell us your favorite club activities you attended last year, (be specific),
and, What Lecture topics do you nominate for future lectures?
_________________________________________________________________________________________
...this version of the Membershipform was revised le 4 septembre 2011 par mmo.