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MOORE
AREA SHAG SOCIETY
MEMBERSHIP APPLICATION
(MUST BE 21 YEARS OLD)
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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).