Kennett Square Area Newcomers' Club Membership Form for 2021-2022
To be included in the Directory, this Completed Form and Dues must be received by
Membership forms are accepted throughout the year.
- PLEASE PRINT CLEARLY -
If you live in a development or subdivision, please provide the name of the development/subdivision___________________________
Please place an asterisk in front of the preferred number.
If you have provided an email address, pertinent last minute alerts and updates,
as well as the Monthly Newsletter, will be sent directly to your inbox.
Birthday: Month____________ Day______________
New Member_________ Renewing Member_________
**Honorary Member (must be a renewing member, age 75 or older) ____
**Honorary Member - Current members age 75 or older are not required to pay yearly dues; however, by choosing this option you forfeit your voting privilege
(Guide and Directory, Page 3, Constitution, Article III, Section 2).
If you don't have a home printer and prefer receiving the monthly Newsletter by regular mail, please check here: ___________________
Please send your check for $25.00 yearly dues, payable to KSANC together with
your completed membership form (please do no staple or tape check to form) to:
Membership Chair: Carol Buckwalter, P. O. Box 171, Landenberg, PA 19350,
610-274-8708 (To be included in the Directory your form and dues must be received by September 30.
I hereby acknowledge that KSANC is not liable for any injury, accident, or loss which
I may sustain at any club function.
Signature: _____________________Date: ______________
We would be pleased to know how you heard about the Kennett Square Area
Friend ______Neighbor______ Local Newspaper______
Website _____Flyer_____ Real Estate Agent _____