Get Out And Live!
(G. O. A. L.)
"Fun and Fellowship" is our motto.
~ Membership Information ~
| Handicapped Travel Club, Inc. Get Out And Live! (G. O. A. L.) "Fun and Fellowship" is our motto. ~ Membership Information ~ |
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Thank you for your inquiry about the Handicapped Travel Club.
Membership Application
(Application Fee of $12 includes first year's dues; annual dues thereafter are $8.)
Last Name:_______________ Husband:_________ Wife:_________
Address:_______________ City:_________ State:____ ZIP:_______
Phone:____________ E-mail:_____________ Ham Call:__________
Number of Children:____ Number of Grandchildren:____
Wedding Anniversary:________
Birthdays: Husband______________ Wife_______________
Type of Disability:_______________________________________
______________________________________________________
Which Member:_____________ How Long:____________________
Use: wheelchair / scooter / crutches / walker /
Other:_______________________________________________
Retired: Husband (yes) (no) Wife (yes) (no)
If not retired, what type of work: Husband__________________
Wife:_____________________
Type of Recreational Vehicle:______________________________
______________________________________________________
Any particular problems in traveling:_________________________
_______________________________________________________
_______________________________________________________
Hobbies: Husband:_______________________________________
Wife:________________________________________________
How did you learn about HTC?______________________________
_______________________________________________________
As a member would you be willing to:
Send news to the HTC Newsletter? (yes) (no)
Work on the Newsletter? (yes) (no)
Work on special projects? (yes) (no)
Serve as an officer or regional director? (yes) (no)
Host a mini rally or the annual rally? (yes) (no)
Other:_______________________________________________
Mail
with dues to:
HTC Treasurer
Tom & Letty Chadwick
190 Fourth Ave.
Estell Manor, NJ 08319
Hm: 609-476-3936
Fax: 609-476-0271
Date:____________________________________