| Last Name: |
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| First Name: |
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| Street Address: |
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| City, State Zip: |
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| Contact Number: |
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| Email Address: |
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| Sponsor's Name, Rank & Org: |
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| Year you originally joined an OWC/OSC: |
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| Would you be willing to serve on the board?: |
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| Volunteer Interests: |
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Fall Bazaar |
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Golf Tournament |
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Airmens' Cookie Drive
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| I understand that my name will be used in a LOSC membership directory for members’ use only. Annual dues of $50 are paid directly to the LOSC. Photographs may be taken at events and used in the ACCents or LOSC web page.: |
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| Special Activities Interest:: |
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Antiques |
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Arts & Crafts |
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Bowling |
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Bunko |
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Bridge |
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Book Club |
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Golf |
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Gourmet |
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Jewelry |
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Mahjongg |
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Scrapbooking |
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Stamping |
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Tennis |
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