Membership Application

MEMBERSHIP APPLICATION

New Membership ________    Renewal _________

Name _________________________________________________  Date ____________

Address _________________________________________________  Unlisted _____

City ___________________________State __________________Zip ______________

Phone (    ) _____________________________________  Unlisted ______

Birth Date  (Month/Day) __________________________________

Email Address ___________________________________________ (confidential)

Would you be interested in serving on any committees? Yes__ No__

If yes, on which committee would you be interested?

Social___ Public Relations___ Refreshments___ Family___ 

Community Service___

Annual Membership Dues: $18.00 Make checks payable to OCS or Omaha Christian Singles

Mail to:  Diane Holmes 803 N. 74th Ave. Omaha, NE. 68114-3111

Any questions contact; Diane Holmes,  dholmes17@cox.net or 402-391-3581

OCS USE ONLY:

 Date Received________ Amount Received________Expiration Date________

BECOME A MEMBER OF OMAHA CHRISTIAN SINGLES