Boston Beanstalks Membership Form

  
  ___Single  ___Married couple  ___Inside New England  ___Outside New England

Please enclose a check payable to The Boston Beanstalks Tall Club for
prorated initial dues. This application is accepted upon your meeting
the club height requirements of 5'10" for women and 6'2" for men.
You must be officially measured (in your stocking feet) by a board
member within four months of receipt of this application or your membership
will be forfeited. You must be a minimum of 21 years of age. Married
couples please fill out two forms and mail together.


Name:____________________________________ Date:______________________



Address:_____________________________________________________________



City:____________________________ State:_________ Zip:_______________



Height:__________________ Sex:_________ Birthday:____________________



Occupation:_______________________ Where:____________________________



Home Phone: (____)______________                       ___Do not list



Work Phone: (____)______________                       ___Do not list



Cell Phone: (____)______________                       ___Do not list



Email Address:_____________________________________    ___Do not list



___Please check if you do not want your address, phones, and email
   available to your fellow Beanstalks in the membership directory.

How did you hear about the Boston Beanstalks Tall Club?



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Please tell us a little about yourself. What have you done and what
has happened to you that might be of interest? Where have you lived,
worked, and/or gone to school? Do you have any hobbies, interests,
pets, family, favorite activities, or other items of interest?



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Please mail this completed form with your initial dues (if you have not
paid them online) to:

Boston Beanstalks Tall Club
P.O. Box 610185
Newton, MA 02461