Celebrating and Serving You

We want to provide you with better service, help you celebrate your "Milestones" and exceed your expectations!  We hate to even ask, but we need a little help from you by updating your membership information.

Please take three minutes to complete the survey below.  All information will be kept in confidence and used strictly to Celebrate You!

Member Name (First & Last) *

Member # *

Member Birthday (Month & Day)

I prefer to have my internet mail sent to the following email address

Business Phone

Home Phone

Mobile Phone

Spouse Name (First & Last)

Spouse Birthday (Month & Day)

Spouse - I prefer to have my internet mail sent to the following email address

Spouse Work Phone

Spouse Mobile Phone

Wedding Anniversary Date



DEPENDENT INFORMATION


A dependent is an unmarried child under the age of 21 (or under 23 if attending college) residing with member.

Dependent Name(s) (First & Last) & Birthday(s) (Month, Day, Year)

We're in the first steps of "going green!" Would you like to receive your monthly statements via email?

Would you like to engage in our “EZ-Pay” Benefit? (For no additional fees, you may pay your membership dues and ancillary fees on a Visa, MasterCard or American Express)

If "Yes," please contact me at the following phone number to set-up my credit card payments:

Have you heard about our Wednesday special guest rate?