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MOORE
AREA SHAG SOCIETY



MEMBERSHIP APPLICATION
(MUST BE 21 YEARS OLD)

Name:________________________________   Spouse:  ___________________________
Birthday: Month ____________   Day _______   Birthday: Month ___________   Day _____
Mailing Address: ___________________________________________________________
City  __________________________________ State ___________ Zip _______________
E-Mail Address  ____________________________________________________________
Home Phone: ___________________________ Work Phone: ________________________

CHECK ONE: New Member ______________  Renewal  ___________________________

The More Area Shag Club is a non-profit / volunteer club. Each member is encouraged to help serve
on a committee. Please indicate your preference. Thanks!!!
By-laws____________            Social ___________        Door & Hospitality ________
Historian  __________             Publicity _________         Membership  _____________
Special Events_______            Other  ___________        Special Talents  ___________
Indicate if you are interested in learning: _________ Basic Shag ______ Int./Advanced Shag

Dues are $20.OO per person each year (May l”- April 31”). Members must be 2I years old at the time
their application is submitted
. A couple may use the same application form. Memberships are to be
renewed each fiscal year. Funds are used for social events, club activities, community service and
publications.  Officers and committee members all work as volunteers and are not compensated for their time.

Please make check payable to M.A.S.S. and mail to:
Moore Area Shag Society
P. 0. Box 992
Southern Pines, NC 28388

By signing this form and accepting membership in the Moore Area Shag Society, I agree to allow my
name, phone number and birthday to be published in a roster available to MASS  members.

SIGNATURE________________________________________  Date __________________
New Member/s Only (needs to complete below this line).
 

Name: ____________________________________________________________________
Sponsoring Members Signature ________________________________________________
(You must be a MASS member to sponsor a new member).