TELEPHONE  PIONEERS
RALEIGH LIFE MEMBERS
Date:_________

NEW MEMBER INFORMATION

 NAME______________________________________________

 ADDRESS___________________________________________

                    ___________________________________________

 HOME PHONE (___)__________  CELL PHONE (___)_________

 WORK PHONE________________________________________

 E-MAIL ADDRESS______________________________________

 RETIREMENT DATE____________________________________

 FORMER EMPLOYER___________________________________

 HOBBIES_____________________________________________

 VOLUNTEER INTEREST (education projects, building, sewing, fundraising, etc)

  1. __________________________________

  2. __________________________________

  3. __________________________________

  4. __________________________________

 ADDED TO THE CALLING TREE LIST____YES_______NO______

(calling tree-advises members of meetings, social events & projects)              

Send To:
Yvonne Tallarino,
6404 Brandywine Road,
Raleigh, NC 27607.