Uxbridge Newcomers & Natives Club

Membership Form

Annual Membership Dues are $25/family. Please make checks payable to: UNNC

Family Name:

Adult(s) Name(s):

Address:

Child(ren)’s Name(s)

Birth Month/year

Phone number:

*Email address:

Would you like to receive a copy of the UNNC directory?

Yes No

*UNNC communicates regularly via email

Please take a few moments to answer the following interest questions on the following page.

We use this information to start new interests groups or to introduce you to others that have similar interests.

Uxbridge Newcomers & Natives Club

Membership Questionnaire

Please answer the following so that we can learn about you and what your interests are.

Special Interest

Adults’ night out	Babysitting co-op	Book Club
Bunco	Community Outreach	Cribbage
Gourmet Club	Guy’s night out	Ladies’ night out
Playgroup	Running Club	Scrapbooking/Arts & Crafts
Tool Club	Walking Club	Whist
Family Outings	Other

General Interest

v Are you interested in attending monthly club meetings?

Yes No

v Are you interested in writing a regular column for the club newsletter?

Yes No

Ø If yes, on what topic?

v Are you interested in organizing any of the above special interest activities?

Yes No

v Please let us know if there is anything special you would like to get from the club (i.e. meet new people, become more active in town)

Please send completed membership forms along with your check to our treasurer:

Lillian Burnat

46 Taft Hill Road

Uxbridge, MA 01569