Join New Member Application Hidden Member Status Current MemberIn ReadingsMoved AwayChanged JobsLost InterestStopped PayingDeceasedNo Reason for ending membership Member status or reason for leaving the club if no longer a member. Inducted Enter date inducted Reading1 Enter date of first reading Reading2 Enter date of second reading Reading3 Enter date of third reading Board Appproved Enter date of board approval Ended Approximate last day of membership Name * First Last * Last Home Address * Home Address Home Address Home Address City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Email * Home Phone Cell Phone * Business Name If applicable. Business Position or Title Business Email Business Address? Different Billing Address? Business Address Business Address Business Address Business Address City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Billing Address Billing Address Billing Address Billing Address City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Date of Birth Spouse/Partner Name Years in Community Past or Present Civic or Service Club Memberships (including other Optimist Clubs) with Offices Held If you have a Life Membership in another Optimist Club, please give the Club Name Special Skills or Hobbies Examples include woodworking, database, crafting. This can help us find areas where you can help. Photo Drop a file here or click to upload Choose File Maximum file size: 8MB Our member handbook includes headshots of members. Youth Contests Please Indicate your interest in the following: Essay Contest coordinate with teachers, publicity and judge Oratorical Contest coordinate with teachers, publicity and judge Visual Arts Competition coordinate with teachers, publicity and judge Youth Photography Contest coordinate with teachers, publicity and judge Senior Scholarship Contest coordinate with teachers, publicity and judge Soccer Recreation coordinate with teachers, publicity and judge Member Related Please Indicate your interest in the following: Adult Socials identify theme, publicize and organize events Membership assist in recruiting and retaining new members Marketing/Publicity contact media with newsworthy information regarding the club Photography provide still pictures and video of club meetings and events Program Speakers identify and arrange speakers for weekly meeting Social Media prepare content for social media platforms, plan social media strategy Youth Activities Please Indicate your interest in the following: Safety on Wheels Bike Rodeo help organize an event with Safety Officers and others to inspect bikes, scooters, and helmets Optimist Club of Naples Spelling Bee Sponsor Name If you do not know anyone in the club just leave blank and we will pair you with someone. Individuals who have committed offenses against children may be denied membership and/or have their membership revoked. Optimist Club of Naples “No-Solicitation” PolicyAs a club who serves as a Friend of Youth, we want our volunteer members to be focused onhelping kids – free from business solicitation of any kind. Therefore all Members arespecifically prohibited from contacting other club members for business solicitation purposes.Your application for membership affirms your acceptance and compliance with this policy. Signature * Date Captcha Future Ideas Submit If you are human, leave this field blank.
