Southern Maryland Social Group
Southern Maryland Social Group
SMSG Membership Form
Print and return to: SMSG ~ POB 1254 ~ White Plains, Md 20695-1254
Membership Type: _____ Individual ($15) _____ Joint ($22)
(Please include Cash, Check or Money Order payable to “SMSG”)
NAME:__________________________________________________________________
PARTNER’S NAME:_______________________________________________________
(if Joint Membership)
ADDRESS:_______________________________________________________________
CITY, STATE & ZIP:_______________________________________________________
YOUR BIRTH MONTH:_____________PARTNER’S BIRTH MONTH:______________
HOME PHONE: __________________________________________________(optional)
YOUR EMAIL:___________________________________________________ (optional)
PARTNER’S EMAIL:______________________________________________(optional)
_______ I/We would like our phone number listed in the SMSG Membership Directory*
_______ I/We would like our Email addresses to be listed in the SMSG Membership Directory*
* Membership Directory is available only to paid members of SMSG.
Tell Us About Your Interests!
_____ Bowling _____ Movies _____Dinner Theatre
_____Theatre/Plays _____Zoo Trips _____Cards/Games
_____ Picnics _____ Fishing _____ Camping
_____ Boating _____ Day Trips
Other Sports:_______________________________________________________________
Other Activities:____________________________________________________________
_____ Parent/Child Activities
Suggestions:_______________________________________________________________
(Please note: Our intent is connect people with similar interests who would like to get together for fun.
It is not the intent of SMSG to take on organizing additional groups, generate charitable funds or to play matchmaker. Group activities will be announced in the newsletter and on the website.)
This information will be used by SMSG Board Members only.
Email SMSG Secretary
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