Kennett Square Area Newcomers' Club
Membership Form for 2020 - 2021
- PLEASE PRINT CLEARLY -
Last Name_____________________________________________First Name_______________________________________Spouse Name________________________________
If you live in a Development or Subdivision please provide the name____________________________________________________________________________________
*If one number is preferred over the other, please place an asterisk in front of the preferred number.
Home Phone___________________________________Cell Phone_____________________________________Birthday Month___________________Day_________________
If you have provided an E-mail address, pertinent last minute alerts and updates as well as the Monthly Newsletter
will be sent directly to your inbox.
New Member_________ Renewing Member__________ **Honorary Member (must be a renewing member, age 75 or older) __________________________
**Honorary Member - Current members age 75 or older are not required to pay yearly dues; however, by choosing this
option they forfeit their voting privileges (Guide and Directory, Page 3, Constitution, Article III, Section 2).
If you don't have a printer and need to receive the Monthly Newsletter by regular mail, please check here ___________________
Please send your check for $25.00 yearly dues, payable to KSANC together with your completed
Membership Form (please do no staple or tape check to form)
Membership Chair: Carol Buckwalter, P. O. Box 171, Landenberg, PA 19350
(To be included in the Directory your form and dues must be received by 9/30/20)
I hereby acknowledge that KSANC is not liable for any injury, accident or loss which I may sustain at any club function.
Please Sign__________________________________________________________________________________________and date____________________________________________
We would be pleased to know how you heard about the Kennett Square Area Newcomers Club
Local Newspaper__________________________ Website _________________________
Flyer_______________________________________ Real Estate Agent___________________