MEMBERSHIP / SUBSCRIBER APPLICATION

Membership Director
Los Angeles Catholic Alumni Club
P.O. Box 7612
Northridge, CA 91326

If your are interested in becoming a member, please print and complete the online membership application, and send it along with a check for $37 for one year to the above address. This application must be completed in full before eligibility can be determined.

The Los Angeles Catholic Alumni Club (LACAC) is open to practicing Catholics, who are single and eligible to marry in the Catholic Church. Additionally, members are college graduates, registered nurses, or have acquired the equivalent in terms of education, experience and/or position.

If you are a divorced Catholic, you may become a newsletter subscriber if you otherwise qualify and a board member sponsors you. E-mail Marie at lacatholicalumniclub@gmail.com for details.

New Member _____ Renewal ___ Newsletter subscriber _____

NAME ___________________________________________________ BIRTHDAY ______/________ (Month / Day)

ADDRESS _______________________________________________________

CITY ________________________________________________ NINE-DIGIT ZIP ____________+_______

PHONE (______)________________________________ E-MAIL _________________________________________

DEGREE - BA - BS - RN - Other ____________________ ( no degree) UNITS COMPLETED ______________________

COLLEGE _________________________ YEAR GRADUATED _______ OCCUPATION ______________________

If you have no degree, please specify education, experience, position. _________________________________________

Are you a Catholic? ______________

Are you a practicing Roman Catholic? No - Yes - Parish _________________________________________________

Are you free to marry in the Church? - No - Yes -

Never Married - Widowed - Annulled ---- If not free, is an annulment in process? N - Y - Annulment Date ___________

How did you find out about the LACAC? ______________________________________________________________

If accepted, would you like to have your NAME, CITY, PHONE, E-MAIL & INTERESTS listed in our club roster? (or any combination of the above, circle choices) Yes No (please initial ________)

We've found that active participation makes the Club even more enjoyable and hope as part of your membership you will sponsor at least one activity a year. Call our newsletter editor for help in planning your event.

HOBBIES AND INTERESTS (list a minimum of four)

I hereby authorize the LACAC to verify the above information. I assume all risks involved in my participation in Club events. I hereby waive any claims against the LACAC, its officers, agents and/or members.

______________________________________________________________ Signature _________________ Date