ATLANTA SKY - HI CLUB
                          Membership  Application
                         * = Required information

I wish to:  Become a Member: ____    Renew My Membership: ____
            Receive the newsletter only: ____
Note: Please do not send payment for dues until you have been voted in.

*Name: _________________________________________________________________

Nickname: ______________________________________________________________

*Address: ______________________________________________________________

*City: _________________________________________________________________

*State: _________         *Zipcode: ________________

*Home Phone: _______________________  Work Phone: ______________________

Occupation: ____________________________________________________________

*Height: ______ ft. ______in.         *Sex: Male: ______  Female: ______

*Birthday: Month: ______  Day: _______

E-mail address: ________________________________________________________

Interests: _____________________________________________________________

Hobbies: _______________________________________________________________

Qualities you seek in others: __________________________________________

           _____________________________________________________________

Are you a member of another TCI affiliated club?     Yes: ___    No: ___

If Yes: What Club: _____________________________________________________

*How did you find out about the Atlanta Sky-Hi Club? ___________________

           _____________________________________________________________

What club activities would you like to participate in?

Social: ___     Administrative: ___     Newsletter: ___

Other: __________________________________________________________________

By signing below, you certify that all statements made in this application
are true and agree and understand that any misstatements of material facts
herein will cause forfeiture on your part of the right to become a member
of the Atlanta Sky-Hi Club. You also understand that the above information
is to be kept strictly confidential and is not a commitment in any way,
shape or form other than to become a Regular Member upon satisfaction of
the membership requirements.

* I accept these terms: Yes: ___  No: ___


Sigend: __________________________________________   Date: ________________
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Send to: Membership, Atlanta Sky-Hi Club, P.O. Box 52579, Atlanta, GA 30355