Community Leaders Association

Membership Application & Renewal

* indicates a required field

Your Contact Information

First Name:

*

Last Name:

*

Home Address:

*

City:

*

State:

*

Zip:

*

E-mail:

*

Home Phone:

Fax:

Business Information

Business Name / Employer:

Title:

Business Address:

Business Phone:

Spouse Information

Spouse Name:

Spouse's Business Name:

Spouse's Occupation / Title:

Spouse's Business Address:

Business Phone:

Mailing Preference

Mailing Preference:

Home
Business
Membership Type

This membership is:

New Membership
Renewal Membership

Membership type:

Fitness Center Membership:

Would you like to add membership to the Gilbert Fitness Center?
No    Yes
For Business and Professional Members
Business Web site: Now you can list and link your business Web site to the CLU Community Leader's Website. If you'd like your web address included, please list it here:

Business members, please list up to 3 additional employees from your company:
Additional business member #1:

Name:

E-mail:

Address:

Home Phone:

Additional business member #2:

Name:

E-mail:

Address:

Home Phone:

Additional business member #3:

Name:

E-mail:

Address:

Home Phone:

Membership plaque

New members, would you like a membership plaque?

Yes
No

Note: Cost for plaque is included in business and family membership fee. CLU employees, due to your reduced cost of membership, we will add a one-time-only $25 fee for plaque.

Yearly chip?

Yes
No

Get Involved!

CLA offers many opportunities to interact with students, faculty and other members. Please indicate if you'd like more information on the following involvement opportunities:

Auction Committee
Membership Committee
Special Events
Golf Tournament (June)
Newsletter
Unsure, but call me when additional assistance is needed in any areas




On the next page you'll be directed to checkout and complete your application.

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