Frontiers International, Nashville Club

Advancement through Service.

Membership Application 2013

First of all, thank you for your willingness to accept our societal obligation to serve others and give
tirelessly in the service of human-kind. In order for us to maintain accurate and efficient records, can you
complete this application as complete as possible. Thanks for your interest in our organization.

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Name: ________________________________________________________________________
Home Address: _________________________________________________________________
City/State/Zip: __________________________________________________________________
Occupation: ____________________________________________________________________
Best means of communication: (Cellular/Email/Physical Mailing) __________________________
Have you ever been a member of Frontiers International? _______________________________
a. If so, what club? __________________________________________________________
7. How did you find out about Frontiers International? ____________________________________
The local and national public relations departments use the following biographical data. For example,
the local secretary to acknowledge your birthday can use birthdays. If you have a resume or articles
about you, please attach this information.

1. Place of Birth: ____________________________

Birthday: ________________________
2. Schools/Colleges Attended: _______________________________________________________
3. To what organizations, churches, and clubs do you belong?
______________________________________________________________________________
4. Your passion for service includes (Please list here your reason for joining the organization and
how you define service to community.) ______________________________________________
______________________________________________________________________________
5. Spouses Name: ________________________________________ Spouses Birthday: __________
6. What areas of the Local Club do you have a particular interest in serving our Nashville
Community? Check all that apply.
___ Public Affairs
___ Financial Committee
___ Membership and Recruitment

___ Intra-Club Activities
___ Community/Education
___ Special Events

___Youth Service/Jr. Frontiers
___ Community Projects

____ Marketing/Promotions/Web-Development
____ Other
_____________________________________________________________________________________
To be filled out internally by a local club member:
1. Fees: Check all that have been received for the interested member.
a. Local Dues ($100.00): ____
National Dues: _____ Foundation Dues: ____
2. Date Paid: ______________________________________________________________________
Presidents Signature: _______________________

Applicants Signature: _____________________

Name of referring member (If applies): _______________________ Date of Application: _____________

Please return this application either to the Nashville Club or referring member or to P.O. Box 68400, Nashville, TN 37206.