Membership Application

1. To complete your application online, please fill out the fields below and click the submit button. Fields with a red * are required.
2. If your application is filled out correctly, you will receive a thank you message on your screen.
3. Friendly reminder: Your membership is not complete until we receive your $60 dues using Zelle, mailed to us, or given in person at an event.

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First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Email *

Phone *

Birth Date (MM/DD/YR) *

As an active member in the Chapter, I would like to VOLUNTEER in the following areas:

Check your interests below. Use the "Suggestions" line to add specific interests not listed: *

Suggestions

in Name Street

Check all the items you agree with: *

I AGREE you can use my full name in Chapter correspondence, i.e., John Smith OR
Please refer to me using my first name and only the first initial of my last name, i.e., John S.
DO NOT share my membership information
DO NOT use my photograph in any Chapter correspondence or website.

Dues: Check all those that apply below. *

Use primetimerscharleston@yahoo.com to ZELLE dues through your bank.
I will mail my check for $60 to Palmetto Prime, PO Box 80842, Charleston, SC 29416.
I will bring my $60 dues and application to the next Chapter event.
I am over 75 years old and will pay $40. through Zelle or bring my application and dues to an event and pay then by check or cash.

Affirmation: Please check the box to indicate that you have read, understand, and agree to the following when you sign and submit this application. *

Palmetto Prime of a Charleston Social Club for gay and bisexual men, and those who identify as male. You must be 21 years of age or older to join. Join our Facebook group page http:/www.facebook.com/groups/247213721786247. Charleston's Palmetto Prime does not tolerate discrimination based on race, color, religion/spiritual beliefs, national origin, or disability. Any member who speaks or acts in a manner contrary to this policy may have his membership revoked. Palmetto Prime is a Chapter of Primetimers Worldwide. Submission of this application affirms your agreement to these policies. I have read the terms and agreements on the webpage and I agree with these conditions.

Signature *

Date *

Email: primetimerscharleston@yahoo.com

USPS: Palmetto Prime, PO Box 80842, Charleston, SC 29416

Website: https://chapters.theprimetimersww.com/charlestonsc/

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