THE PENINSULA BREAKFAST CLUB
Peninsula Breakfast Club, P.O. Box 7914,
San Diego, CA 92167
Membership Application
(Please
print out and mail)
Name
__________________________________________
Occupation/Title________________________
Business
Name ________________________________________________________________________
Address
______________________________________________________________________________
_____________________________________________________________________________________
Telephone
____________________ Fax
_____________________ E-mail ________________________
Nature
of business
_____________________________________________________________________
Operated
out of (circle one) Home
Office
Year business established ________________________
Please
list other organizations to which you belong:
_____________________________________________________________________________________
_____________________________________________________________________________________
What
are you expecting of this Club?
_______________________________________________________
____________________________________________________________________________________
What
will you add to the Club?
____________________________________________________________
_____________________________________________________________________________________
Date
of your first attended meeting: ___________ who invited you?
_____________________________
Personal
References:
Business References:
1.
_________________________________________
1. _____________________________________
2.
_________________________________________
2. _____________________________________
Please read:
This application does not constitute acceptance.
We reserve the right to refuse any entry at our discretion.
The Peninsula Breakfast Club, Board of Directors, Officers or Members do
not accept any responsibility for personal injury, accidents, or liability for
lawsuits resulting from the participation before, during, or after any scheduled
or unscheduled event of the Peninsula Breakfast Club.
In other words, you are joining and participating at your own risk.
Submission of a completed and signed application is an acknowledgment
that you have read, understand, and accept the information provided in the
Membership Information Package.
Signature:
____________________________________
Date: __________________________________
Send this completed application sheet and
a check for $115.00 made payable to the Peninsula Breakfast Club, to:
Peninsula Breakfast Club, P.O. Box 7914,
San Diego, CA 92167