The Cocktail Club:
New Member Nomination Form

All proposals are due no later than Friday, August 24th.
 

Proposed member's name *
Proposed member's name
Proposed member's address *
Proposed member's address
Proposed member's cell phone *
Proposed member's cell phone
Please provide first and last name
Date submitted *
Date submitted


This is an application for membership only.  Current Cocktail Club voting procedure will determine final membership. 
The Cocktail Club and its members are not liable for any damages associated with membership or application for membership.