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Women’s Club Membership Application Form

Membership Dues:  $26 a year.  Paid Annually, every 12 months

Important Note:  If you are sending in a your CHECK, you must complete and print this membership form and send it with your check attached to the application form.  Do not complete the online form unless you are paying by credit card with our online system.

___  Regular Member:  Lives on Island Estates or lived there and moved away

____ Associate Member: (previously known as Sponsored Member).  No Sponsorship Required. 

Today’s Date: __________________  
Email:________________________________________________ Phone _____________________

First Name: _____________________  Last Name: _______________________________________

Mailing Address: ___________________________________________________________________  
Unit # ____________  
City:_____________________________  State:______  Zip: ________


Husband/Significant Other________________________

Birthdate (MM/DD/YEAR) For recognition of milestone birthdays  ______________


Check Please:  Mail this form, with your check to payable to IEWC to Patti Jucha, 763 Harbor Island, Clearwater, FL  33767.  If you are renewing, and there are NO changes, no form is needed.  Questions:


We welcome you to the Island Estates Women’s Club and look forward to seeing you at a luncheon or event soon.

Important Information: 

*  Dues are paid Annually. Dues are paid every 12 months.  You will receive a reminder a month before they are due.  

*  Please be sure to add the Membership emails to your email contact list so that you receive important information from our Membership Chair. and

*  The club takes pictures at our activities and does post them on our website and on Facebook.  


REMINDER:  DID YOU ATTACH YOUR CHECK to this form?  Your Membership Application must have your check attached.  Thank You.

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