Square and Circle Club
Application for Membership
Name:_________________________________________________
Address:_______________________________________________
City: ___________________________________ZIP:____________
Phone: (____)___________________________________________
Email: _________________________________________________
Spouse’s name: _________________________________________
How did you learn about Square and Circle?
______________________________________________________
______________________________________________________
______________________________________________________
Please check areas of interest:
____ Community Service
____ Scholarships
____ Fund Raising
____ Membership
____ Event Planning
____ Other:
______________________________________________________
______________________________________________________
______________________________________________________
Signature of Applicant _______________________________Date_______
Please send membership applications to:
Square and Circle Club
P.O. Box 640137
San Francisco, California 94164-0137