THE ADVENTURERS' CLUB OF HONOLULU
Application for Membership
Home Address ________________________________________________________
Phone_______________________________________ Fax___________________
e-mail_______________________________________
Year of Birth (optional) ________________ Place of Birth: ____________________
Occupation: ______________________________ Education______________________
Name of Spouse: __________________________
Qualifications: The Club was organized to promote adventure and knowledge of the sciences,
arts, and humanities among those who have left the beaten path and sought knowledge and adventure.
Please list your adventure/travel history and furnish information or special knowledgearts, and humanities among those who have left the beaten path and sought knowledge and adventure.
that will further your claim. Attach additional sheet if necessary.
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Future Adventure Plans: ______________________________________________________________
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Favorite Sports / Hobbies: ______________________________________________________________
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Other Club Affiliations:________________________________________________________________
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_____________________________________________(continue on separate sheet if necessary)
Please mark X where you would be willing to participate if selected for membership:
__Do a program; __Help find programs; __Help select meeting locations;
__Take telephone or email reservations and collect for meals.
Serve as: __Treasurer/Asst; __Secretary/Asst; __Membership Chair/Asst; __Program Chair/Asst; __Director on the Board;
Applicant Signature______________________________________________
Sponsor's name / Signature ________________________________________________
INSTRUCTIONS: Fully complete the Application Form and mail it with a cheque, in the amount of $25, payable to Adventurers' Club to:
Membership Chair: Janet M. Miller, 2665 Peter Street, Honolulu, HI 96816-2013
(phone: 808.732.3506 email: miller@hi808.us )
You are welcome to attend meetings while your application is being processed. Annual dues are $40.00 and $25 for enrolled spouse members, $25 for non-resident members. First year dues are prorated at $3.33 per month if application is approved after January. Once approved, you will be billed for your annual dues.
Official use only:
Membership Chair's Signature____________________________ New Member No. ______
President's Signature____________________________________
