RETURNING MEMBER APPLICATION

Greetings! GLOSS is delighted and thankful to have captured your interest!!

GLOSS is delighted and thankful to have captured your interest for the 2023-2024 year!!

Please complete the returning member form and submit renewal fee of $50 via a method below:

· Online: Pay Here

· Check: Payable to GLOSS - PO 870762, Stone Mountain, GA 30087

· CashApp: Pay Here OR $GLOSSsis

If you have questions, you may contact our Membership Director, Marla Singleton at GLOSSmembership@gmail.com.

Which local GLOSS Chapter are you currently apart of?

Is the GLOSS member a Butterfly or Caterpillar?

APPLICANT'S CONTACT INFORMATION

Name

First Name

Last Name

Mobile Number

(###)

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Home Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

County

ABOUT THE APPLICANT

Age

Date of Birth

T-Shirt Size

School/College

Grade/College Year

Place of Employment/Service

Place of Worship/Church

Is the applicant willing to accept only God's best for her life?

Is the applicant willing to obey Biblical truths?

APPLICANT'S PARENT OR LEGAL GUARDIAN INFORMATION

Mother's/Legal Guardian's Full Name

First Name

Last Name

Phone Number

(###)

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Father's/Legal Guardian's Full Name

First Name

Last Name

Phone Number

(###)

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Please fill out the next section, if you would like to add an additional emergency contact.

EMERGENCY CONTACT

Emergency Contact Full Name

First Name

Last Name

Relationship to Applicant

Phone Number

(###)

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