Please print this form and return it completed, along with your check payable to Delta Delta Delta to:
Jane Ward
17324 Eaton Lane
Monte Sereno, CA, 95030

Name_____________________________Maiden Name______________Husband’s Name___________

Street Address_________________________________________________________________________

City_____________________________________________State________Zip______________________

Telephone (Home)_______________________ Telephone (Work)______________________________

Fax # __________________________________  Email__________________________________

College or University of your Collegiate Chapter_____________________________________________

Birthday: Month_____Day___ 

Profession/Employer:____________________________________________________________________

Interests/Hobbies/Announcements:________________________________________________________

Volunteer Organizations:________________________________________________________________

Would you be willing to hostess a meeting in your home? Y or N

Would you be willing to co-hostess a meeting (supply refreshments/clean up)? Y or N