(One Application Per Person) 
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Date________________________________
Last Name_____________________________________________
First Name________________________________M.I. _________
Naples Address________________________________ZIP_______
Naples Phone (_____)____________________________________
E-Mail Address_________________________________________
Number of months residing in Naples each year________
Northern Address_______________________________________
City, State, ZIP_________________________________________
Northern Phone (_____)________________________
Birthdate _______________ / _________________
The annual membership fee is $20.00; after May 1st dues will be $15.00, after September 1st dues will be $10.00. This only applies to new members not existing members who are late paying.
PLEASE MAKE CHECKS PAYABLE TO: NAPLES WALKING CLUB
Questionnaire
I have experience in helping to conduct events:
Limited:___________ Lots:_________________
I will help the club put on special events as needed: ______
I am interested in helping the club in the following ways:
Host a social event at my home/clubhouse, etc.: [ ] Yes [ ] No
Host a club walk in my area: [ ] Yes [ ] No
I want to help the club wherever needed: [ ] Yes Put me to work [ ] Yes
CLUB SHIRTS ARE AVAILABLE
The club shirts are white with the club logo on the front. Our club mascot is the Brown Pelican. He is dressed as a walker.
Sizes: SM (30-32) MED (34-36) LG (38-40) XL (42-44) XXL (46-48)
Price: T-shirts and tank tops $10.00 each. Sweatshirts are $20.00 each.
SIZE:______
MAKE CHECK PAYABLE TO: NAPLES WALKING CLUB
PLEASE MAIL MEMBERSHIP APPLICATIONS TO:
NWC Membership
695-3 Luisa Lane, Naples
Naples, FL 34104
Rev: 04/07/04 mgs