Membership Request Form

FGCU Fencing Club

Membership Request Form

Please note that this form is in the process of being revised. If you are interested in fencing with us, send an email to fencingclub@eagle.fgcu.edu

Contents

Contact Information
Student ID number
GPA
FGCU Class Rank
Date you Started Fencing
Fencing Experience
Emergency Contact Information
Membership Type

Please provide the following contact information:

First Name
Last Name
Middle Initial
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Cell Phone
Home Phone
E-mail

What is your Student Identification Number?
What is your Cumulative GPA ?
Choose your status from the following options:

`
Enter the date you started fencing - if applicable :
Please describe your experience with fencing so far?
Please provide the following emergency contact information:

First Name

Last Name

Relationship

Phone

E-mail
Choose one of the following membership types:

Greg Tenn.
Copyright © 2006 [FGCU Talons]. All rights reserved.
Revised: October 25, 2006

© FGCU Fencing Club

Last update: February 21, 2007

Contact: fencingclub@eagle.fgcu.edu