Club “Q” Membership Form ← BackYour information has been sent. Thank you for your membership submission, your information has been sent to the membership committee, they will be reaching out to you directly. First Name(required) Last Name(required) Address(required) City(required) State (required) Zip (required) Phone Number(required) Email(required) Household: (Dependents) those you claim on your yearly 1040 Federal income tax filings. Dependents(required) Yes No Name Age Gender Male Female Name Age Gender Male Female Name Age Gender Male Female Name Age Gender Male Female Name Age Gender Male Female Family History: Please define your family tree: relation to John Isaac and Louise (Matthew) Queenan (i.e., your mother/father names, grandmother/grandfather, great grandmother/grandfather, etc.) Family History NOTE: Club dues are paid annually, $50 for singles and $100 for family households. A household consists of spouses and their depends, who are claimed on their 1040 Federal income taxes filing. SubmitSubmitting form Δ Share this: Share on X (Opens in new window) X Share on Facebook (Opens in new window) Facebook Like Loading...
Club "Q" 