ONLY IF YOU ARE A MEMBER OF DALLAS COUNCIL 799

Registration Form

Membership Number:  

Home e-mail address:  

Spouse Name:

City:   State:    Zip: 

Home phone:     Work: 
                      Example XXX_XXX_XXXX                            Example XXX_XXX_XXXX
Cell Phone:        Fax:    
                      Example XXX_XXX_XXXX                           Example XXX_XXX_XXXX
         Pager:   
                      Example XXX_XXX_XXXX

Your Church/Parish:

In order to reduce printing and mailing costs, we would like to send newsletters and other calendar changes by email.  Would you like to participate in this way?  Yes    No

Which e-mail address would you prefer for mailings?  Home Work Both
What type Computer do you have?  Macintosh PC
What Speed is your modem?  28.8 56K Direct Line Don't know
Which browser do you have?  Netscape Internet Explorer Don't Know

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