PARROT HEADS OF THE TRIAD
PRINTABLE MEMBERSHIP FORM
Date:_______________ Name:____________________________
Spouse: _______________ Email(s): ___________________________
Phone: ___________________ Other phone: ____________________
Street Address: ________________________________________
City, State, Zip: ______________________________________
Birthday: ______________________ Spouse Birthday: _____________________
Occupation: ________________________ Spouse Occupation: _________________
Favorite Charity: ____________________________________
I would like to volunteer with club
administration and/or events: ____
It is ok to include my phone number & address on the club directory for members
only:
YES___ NO___
I have read and understand the
guidelines of the Parrot Heads of the Triad: _____
How did you hear about the club? _______________________________________________
Occasionally, we post photos on our website... it is ok to post my picture if
applicable:
YES___ NO___
If you require special services or handicap access, check here:______
Please see
DUES for application fee. Make checks payable to Parrot Heads of the Triad
& return to:
Treasurer,
Parrot Heads of the Triad, 3750 Squirewood Drive, Clemmons, NC 27012
Club hotlines: (336)922-9403 or (336) 672-2453 Club email: Triadparrotheads@yahoo.com
The Parrot Head Club of the Triad is an officially chartered club sanctioned by the Parrot Heads in Paradise. The Parrot Head Club of the Triad embraces the following statement of purpose: "The local Parrot Head clubs are not for profit organizations whose purposes are to provide a variety of social activities for people with similar tastes and interests and to assist in local community and environmental concerns." Any money or items given to the club for charitable or membership reasons are not deductible as a charitable contribution for federal income tax purposes. PRINTABLE MEMBERSHIP FORM