1. Complete the form, filling in the blanks.
Name of Candidate
Residence Address
City, State, Zip
Home Phone
E-mail
Date of Birth
S.S.#
Classification:
Categories:
Please charge Annual Fitness Center privileges to my account
Employer
Title / Occupation
Work Address
Work Phone
Fax
Education
Spouse's Name
Spouse's Employer
Children
Proposed by
Signature
Seconded by
2. Print form out and send with two letters of proposal, one from you and one from the seconder to:
The Elective Committee
215 S. 16th St. Phila.,PA 19102
c/o Edward M. Noll
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