Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. Request for PACC Membership Form Mission Statement of PACC The objective of the founders of the Polish American Citizens Club are to unite members in a fraternal friendship, to promote and encourage good fellowship, to assist them in case of need and provide members with the convenience of a club house. Members enjoy club events, the company of club members and use the club for special occasions. Club members work together to support club functions, community events and private parties, which serve as the main fundraising activities. Membership requirements are simple. According to the By-Laws, to become a Regular Active member you must meet the following requirements: ·You must be a citizen of the United States or have declared intention to become a citizen. You must be of Polish or Slavic origin or decent, which means you can identify at least one ancestor who was from the region comprising Poland, Slovakia The Czech Republic and regions of surrounding countries where Slavic language is spoken. Or if you are a spouse of a regular active member regardless of your nationality. ·You must be at least 21 years of age. You must appear before the Board for review of your qualifications. The next board meeting can be found on our website www.paccwhs.org/meeting-schedule ·You must be present at a regular meeting to be sworn in as a member. ·To continue as a member in “good standing” yearly dues of $30 must be up to date. ·You must attend at least three (3) club meetings over the course of the year Please attend the next Board meeting to apply and learn more information. OK Question Title * 1. Personal Contact Info Name (First & Last) Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 2. What is your preferred way of contact? By email By phone/text By mail No preference OK Question Title * 3. Please provide the following -Birth Date:Ethnicity (Podhodzenie):Citizenship: Filed Intention for CitizenshipMother’s Maiden Name: Father’s Name: Parent’s Ethnicity: OK Question Title * 4. What is your profession? OK Question Title * 5. Outside of your professional life, what do you find inspiring? What are your talents and/or interests? OK Question Title * 6. What talents/interests could you contribute to the club? Bartender Set up/break down events Prepare food trays Cook Serve at buffet line Waitress Hostess Public speaking Collect 50/50's at events Greeter Decorate Paint Plumber Electrician Carpentry Dish washer Landscape Organize supplies Gardening Plan events Graphic design Advertise Build community partnerships Writing skills Other (please specify) OK Question Title * 7. Availability to volunteer (days of week/times) OK Question Title * 8. Do you know the club offers private events to club members and the community? Yes No OK Question Title * 9. Are you interested in working private events (typically on Friday, Saturday & Sunday)? Yes No OK Question Title * 10. Do you use Facebook? If so, "Like" & follow PACC's page for upcoming event information. Do you look at PACC's website to find out about upcoming events? Yes - I use Facebook & look at PACC's website Yes - I use Facebook Yes - I look at PACC's website No - I don't use Facebook or look at PACC's website No - I don't use Facebook No - I don't look at PACC's website OK DONE - THANK YOU!