Membership Application

First Name (s):
Last Name (s):
Address:
City: State: Zip:
Phone Number:
Email (s):

Tell us about yourself.

Annual Dues

Single Parrot Head .....$30.00
Mr. & Mrs. Parrot Head ..$50.00
Significant Others (Anchored in the same harbor)...........$50.00
 All memberships are for one calendar year - starting at the first every year.
Please make checks
payable to:
Club Finz
P.O. Box 4555
Portsmouth, NH, 03802
Birth Day (s):
Occupation (s):
Favorite JB song:
Nicknames:
Hobbies/
Volunteer Work: