MEMBERSHIP / SUBSCRIBER APPLICATION

    Membership Director

    Los Angeles Catholic Alumni Club

    P.O. Box 7612

    Northridge, CA 91327

    If your are interested in becoming a member, please print and complete the online membership application, and send it along with a check for $37 for one year to the above address. This application must be completed in full before eligibility can be determined.

    The Los Angeles Catholic Alumni Club (LACAC) is open to practicing Catholics, who are single and eligible to marry in the Catholic Church. Additionally, members are college graduates, registered nurses, or have acquired the equivalent in terms of education, experience and/or position.

    If you are a divorced Catholic, you may become a newsletter subscriber if you otherwise qualify.  E-mail Marie at lacatholicalumniclub@gmail.com for details.

    New Member _____ Renewal ___ Newsletter subscriber _____

    NAME _________________________________________________ BIRTHDAY ______/________ (Month / Day)

    ADDRESS _______________________________________________________

    CITY ________________________________________________ NINE-DIGIT ZIP ____________+_______

    PHONE (______)________________________________ E-MAIL _________________________________________

    DEGREE - BA - BS - RN - Other ____________________ ( no degree) UNITS COMPLETED _____________________

    COLLEGE _________________________ YEAR GRADUATED _______ OCCUPATION ______________________

    If you have no degree, please specify education, experience, position. ________________________________________

    Are you a Catholic? ______________

    Are you a practicing Roman Catholic? No - Yes - Parish _________________________________________________

    Are you free to marry in the Church? - No - Yes -

    Never Married - Widowed - Annulled ---- If not free, is an annulment in process? N - Y - Annulment Date ___________

    How did you find out about the LACAC? ______________________________________________________________

    If accepted, would you like to have your NAME, CITY, PHONE, E-MAIL & INTERESTS listed in our club roster? (or any combination of the above, circle choices) Yes No (please initial ________)

    We've found that active participation makes the Club even more enjoyable and hope as part of your membership you will sponsor at least one activity a year. Call our newsletter editor for help in planning your event.

    HOBBIES AND INTERESTS (list a minimum of four)

    

    I hereby authorize the LACAC to verify the above information. I assume all risks involved in my participation in Club events. I hereby waive any claims against the LACAC, its officers, agents and/or members.

    ______________________________________________________________ Signature _________________ Date