Fillable Norwood Editable NW Application 720180716

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Norwood Editable NW Application 720180716

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APPLICATION FORM
241 West 14th Street
New York, NY
10011
M E M B E R S H I P C AT E G O R Y:
Individual Spouse/Domestic Partner Under 30
PAYMENT DETAILS:
Initiation and First Year Annual Dues will be
deducted only on granting of membership.
Check Enclosed
C R E D I T C A R D :
Visa Mastercard American Express
CREDIT CARD NUMBER
EXPIRATION DATE SECURITY CODE
SIGNATURE
What is your involvement with the Creative Arts?
What is your most satisfying accomplishment?
Who would you most like to collaborate with?
What would you expect from a modern day arts club?
What else would you like us to know about you?
I hereby apply for membership of Norwood. If accepted
I agree to be bound by the Rules of the Club.
Applicants must be at least 21 years of age.
Applicants may be placed on a waiting list, any membership
invitation remains at the discretion of the club.
All information will be held in strictest confidence.
Date of Application
| |
P H O TO G R A P H
Applicants can email a jpeg photograph
to the membership secretary at
membership
@
norwoodclub.com
NAME (PLEASE PRINT)
ADDRESS
CITY STATE
COUNTRY ZIP CODE
CONTACT NUMBER 1
CONTACT NUMBER 2
EMAIL
AGE 21-29 30-39 4
0-49
50-59 60-69 70 and above
PROPOSER
SIGNATURE
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Norwood Editable NW Application 720180716

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Completed 10 May 2021

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