Membership Application

About You
First Name *
Last Name *
Mailing Address *
City *
Zip *
E-mail *
Cell/Home Phone *
Office Phone
Birthday
Spouse’s Name
Your Work
Employer *
Job Title *
Time at Current Job *
Is Your Employer a GKCC Member? *	Yes No
Business Address *
City *
Zip *
Best Time For Meetings *	Morning Lunch After Work
Best Day To Meet *	Monday Tuesday Wednesday Thursday Friday
Is your spouse joining also? *	Yes No
Where would you like the invoice sent? *	Send it to me Send it to my employer
Your Interests
Check all that you are interested in	Business Networking Community Service Professional Development Leadership Opportunities Social Events Public Relations
What do you expect to get out of joining the GKYP?

I am aware of the requirements and obligations set forth for membership in the Greater Killeen Young Professionals. I agree to complete these requirements.