NATIONAL ALUMNI CLUB

MEMBERSHIP APPLICATION

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H.C.S.C. Alumni Club, Inc.

National Club Application

(Please print)

 

Name: _________________________________________________DOB_______________

 

Spouse’s name: ____________________________________________________________

 

Address:  __________________________________________________________________

 

City:  ____________________________________ State: _______ Zip code: ___________

 

Phone: ____________________________________________________________________

 

Cell Phone: ________________________________________________________________

 

E-mail address: _____________________________________________________________

 

Date started with JCPenney: ___________________________________________________

 

Date retired/resigned from JCPenney: __________________________________________

 

Last assignment:  ___________________________________________________________

 

Last location: _______________________________________________________________

 

Local Meeting Group(s) I want to join: __________________________________________

 

_________________________________________________________________________________________

 

(Dues for the National Club are waived for the first calendar year.)

You will be billed the Annual Membership fee, currently $25, each year

thereafter. Dues for the Local Meeting Groups can be found on the

website  www.jcpalumniclub.org

 

Mail application form to:

National H.C.S.C. Alumni Club

P O Box 261978

Plano, TX 75026-1978

 

 

More information can be found on the Club's website,

www.jcpalumniclub.org .

 
 
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