New Member Form

Hi-Desert Fellowship

(Yucca Valley Alano Club)

PO Box 1285

Yucca Valley, CA 92284

yvalanoclub.com

Note:

After submitting this form, the membership chair will welcome you as a new member, and provide you with options to pay your dues and complete your membership.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

Sobriety Date or Al-Anon Recovery Date

YYYY

Comments