Prospective Member Questionnaire/ Application

Questionnaire / Application for Prospective Members

Name*
First Last
Email Address*
Enter Email Confirm Email
Home Phone Number*
Cell Phone Number*
Address / Residence*
Please make sure to include city, state and zip code)

Street Address Address Line 2 City State ZIP Code
Primary Address?*
Is the address provided above your primary residence (i.e. Is this the address on your driver's license and federal tax return)?
- Yes
- No (pls. answer question below)
If you answered "No" above, pls. provide your primary address below.
Your Birthday
Only if you feel like it!
MM
DD
YYYY

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Organizations*
What other organizations or groups in NYC are you a member of or are affiliated with? If none, just write "none."
Additional Info*
Pls take some time to provide additional information to help us get to know you (special interests, education, philosophy, professional and/or volunteer activities, talents and capabilities, hobbies, spouse/ partner, kids/ grandkids - whatever!) *This is the most important question on this form and we appreciate you replying fully! This is your chance to shine!
Your Event Date*
Pls. refer to the MWC Calendar on our website and choose a date when you can commit to organizing a qualifying event or recurring activity for the membership. Suggestions and guidelines as to what qualifies as a membership event are on the MWC website in a recent post. Once you have selected a date, pls. fill out and submit the "Create An Event" form on the menu ribbon on the home page of the website.
Date
Date Format: MM slash DD slash YYYY
Dues*
For the 2023 Membership Year the MWC will NOT have dues. However, we reserve the right to reinstate them beyond that timeframe if we find it is necessary. Please check here to indicate that you are aware this is a possibility. The last year we charged dues they were $150; they may or may not be increased if they are reinstated. Dues are not pro-rated for periods of less than a year although reduced mid-year dues have been offered previously on a one time basis for new members only.
- Yes, I know the MWC may reinstitute dues.
CONFIRMATION: MWC Membership Interest*
Pls. check "YES" below to acknowledge that you want to be a member of the Manhattan Women's Club and are familiar with the MWC's new operating structure which requires a defined minimum level of participation.
Untitled*
- YES
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Questionnaire / Application for Prospective Members

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