** For updated info click CTR & F5 **
 
PRINT FORM, FILL OUT AND MAIL IN (Click FILE, PRINT, OK)
For more info or paper form, call Michelle 216-251-4222

Name: ________________________ Today's Date:____/____/____
Address:_______________________ Birthday:       ____/____/____
Apt.#:_____ City:________________ State:  OH  Zip:_______
Phone:    _(____)________________ I want my number: ( )listed ( )unlisted
Education:_____________________ Job/Career: ____________________
Parish: _______________________ Other: _________________________
Email:_______________________________________________________

I meet the following requirements for membership and the above info is correct.
      1. I am 21 years old or older.
      2. I am Catholic
      3. 1 am Single (never-married, annulled or widowed)

Signature: _____________________________________________________

Check your interests and talents below:                         DUES SCHEDULE
                                                                                        Includes $2 Processing fee
Are you interested in . . . ?                                              January  $16.00
_____ Arts and Theater _____ Newsletter                     February 14.50
_____ Social Events       _____ Athletic                         March      13.00
_____ Spiritual               _____ Membership                  April        11.50
_____ Civic Services     _____ Scrapbook                      May         10.00
                                                                                         June          8.50
Can you help with any of the following . . . ?                 July            7.00
                                                                                         August    23.50   (13 mo.)
_____ Arts / Graphics     _____ Computer                    Septembe 22.00
_____ Public Speaking   _____ Printing                        October   20.50
_____ Accounting           _____ Photography                November 19.00
_____ Music/Singing       _____Offer rides                     December 17.50
_____ General help         _____ Other: ____________________________
OTHER ORGANIZATIONS:______________________________________________
Were you an officer? List:_________________________________________
Would you like to be an officer or committee chairperson : ( ) Yes ( ) No
PRINT FORM, FILL IN ABOVE INFO AND RETURN with pro-rated dues for this month. Make check to: CAYOMAW CLUB. Mail payment to: Lawrence Oravec, Cayomaw Asst. Treasure, P.O. Box 81721, Cleveland, OH 44181. E-mail: cayomaw@excite.com

ASSISTANT TREASURER USE ONLY
Payment Type: ________________ Amount:_________ Date: ____________