Membership Form - Keesler Spouses Club

Keesler Spouses Club
Membership Form
Activity Groups
(Select All That Apply)
Bunko
Discovery Club
Little Dragons Playgroup
Book Club
Mahjong
Lunch Bunch
Board Position Interests (Elected Officers) Area of interest:
President
Vice President
Second Vice President
Secretary
General Treasurer
Welfare Treasurer
Special Committee Interests (Voluntary Standing Committees)
Auction
Programs
Ways & Means
Welfare
Membership / Sunshine
Volunteering Interests
Name
Thrift Shop
Base Events
Child Pride Day
MS Special Olympics
Halloween Trunk-or-Treat
Other:
Personal Information
Last Name
First Name
Address
City
State
Zip Code
Phone
Email
Birthday Month --Select--
Day --Select--
Spouse’s Information
Spouse's Name
Organization
Please Note: We maintain a KSC Roster that is provided via email to active members for the purpose
of conducting official KSC Business.
- Membership Dues: $36 per year
- Please fill out this form, save it, and e-mail it to: [email protected].
- Please mail a check to Keesler Spouses Club, P.O. Box 5218, Keesler AFB, MS 39534
- Check or Cash with application may be delivered to the Thrift Shop (Bldg. 1704 Meadows Dr.)