APPLICANT INFORMATION: |
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| YOUR NAME | ___________________________________ |
| Co-HABITING COMPANION'S NAME | ___________________________________ |
| MAILING ADDRESS | ___________________________________ |
| CITY/STATE/ZIP | ___________________________________ |
| TELEPHONE(S) | ___________________________________ |
| E-MAIL ADDRESS: | ___________________________________ |
| I WOULD LIKE TO RECEIVE NSM NEWS BY (CHOOSE ONE): US MAIL ( ) or E-MAIL ( ) | |
| DO YOU WANT YOUR E-MAIL ADDRESS VISIBLE TO OTHER RECIPIENTS? YES ( ) or NO ( ) | |
| WOULD YOU BE WILLING TO HOST A POTLUCK OR OTHER EVENT IN YOUR HOME? YES ( ) or NO ( ) | |
| ARE YOU INTERESTED IN ASSISTING THE STEERING COMMITTEE IN PLANNING / ORGANIZING EVENTS? YES ( ) OR NO ( ) | |
| MEMBERSHIP DUES ENCLOSED: SINGLE $10 / YEAR ( ) COUPLE $15 / YEAR ( ) | |
| REMIT TO: NSM, PO BOX 4444, PEABODY MA 01961 MAKE CHECK PAYABLE TO "NSM" | |
mail it to: NSM, PO BOX 4444, PEABODY MA 01961 Include your check or money order made payable to NSM. No cash please. Our members receive quarterly newsletters, calendars, updates and reminders of all of our events. Please refer to our website to keep informed of our events until your newsletter arrives. And feel free to contact any member of the steering committee listed on the CONTACT NSM page. |
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