NAME: ___________________________________________________________________ STREET ADDRESS: _______________________________________________________ CITY: ______________________________ POSTAL CODE: ______________________ TELEPHONE NUMBER: (519) ________________________________ EMAIL ADDRESS: _________________________________________________________ FIRST NAME OF WIFE OR PARTNER: _______________________________ INTERESTS: Please list your interests, hobbies or talents which could be shared or be of benefit to members of the Club. ___________________________________________________________________________________ ___________________________________________________________________________________ COMMITTEES: Please check off any committees you would be willing to serve on

Programme (Speakers, Tours)	___	Activities (also Events, eg. Barbecue)	___
Membership (Applications, Directory, Health of Members)	___	House (Meeting arrangements, Refreshments, A/V Equip.)	___
Communications (Newsletter, Website)	___	Finance (Financial affairs, Budgets)	___

Please submit to Ron Durst, RCMC Treasurer, 43 Kortright Road East, Guelph, ON, N1G 4M6 or John Proctor, RCMC Membership, 44 Rickson Avenue, Guelph, ON, N1G 2X1. -------------------------------------------------------------------------------------------------------------- Area below for Club Administration

SPONSOR'S NAME: (Please print) ___________________________________________ DUES PAID: __________________________ DATE:________________________ COMMENTS:_________________________________________________________________________ ______________________________________________________________________________________

Reviewed by:

Membership ___ Treasurer ___ Board ___ Commun. ___