German American Club

Gesangverein, Inc

Membership Application Form

First Name: _______________________________M.I.: ____  Last Name: _______________________

Occupation: __________________________________________

Spouse: ________________________________ M.I.: ________

Occupation: __________________________________________

Address: _______________________________________________________________ Apt: _______

City: _____________________________________________ State: ______ Zip: _________________

Home Phone: ______________________________

E-mail: ____________________________________________________________________________

Date of Application: ________________________________

Type of Membership: ___________________________

                                   Family: $60.00 or Single: $35.00

                                   Student (ages 16-23): $17.50

Enclose Check or Money Order Payable To German American Club Gesangverein, Inc

Mail To:

German American Club Gesangverein, Inc.

PO Box 39243

Louisville, KY 40232-9243