Associate Member Application

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First Name

Last Name

Maiden Name

Maiden Name (if applicable)

Birthdate

Email

Phone

Year you joined the club

Spouse Name (if applicable)

Instagram Handle

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Member Occupation

Company

Child 1 Name

Child 1 Birthday

Child 2 Name

Child 2 Birthday

Child 3 Name

Child 3 Birthday

Child 4 Name

Child 4 Birthday

Do you allow your children to be pictured in HJWC social media postings for events in which your family attends?

I approve my child/children to be pictured in HJWC social media

I do not approve my child/children to be pictured in HJWC social media

Thank you! We’ll be in touch.

Email us:

Find us:

P.O. Box 152, Hinsdale, IL 60521