Family Synergy - Provisional Membership Application

Provisional Membership Application

FAMILY SYNERGY PURPOSE AND BASIC PREMISE FAMILY SYNERGY is a non-profit volunteer run educational organization for people interested in non-possessive, caring interpersonal relationships. We believe that people can live fuller, more rewarding lives, achieving more of their potential, if they develop an increased awareness of their freedom of choice concerning interpersonal relationship styles and, that given an increased awareness, some may select open multiple committed relationships. Membership is open to all over 18 years of age who are interested in the purposes of FAMILY SYNERGY, are respectfully tolerant of those whose lifestyles may be different from their own, and who have fulfilled the requirements of membership. Members of families and singles are welcome. PROVISIONAL MEMBERSHIP APPLICATION Provisional Membership is good for 6 months from date of application

Family PROVISIONAL membership (2 persons): $40.00 Each additional (in same domicile): $10.00 Single PROVISIONAL membership: $30.00
How did you hear of Family Synergy?: __________________________________________________________________________
Upon becoming a Full Member of Family Synergy (check the appropriate answer):
Shall we list you in the Family Synergy Membership Directory?	Yes No
To save FS money, receive your Newsletter electroncally (email)?	Yes No
If hosting events, can your address/telephone information be sent to members electronically?	Yes No
Is your home available for overnight guests?	Yes No
Is your home available for meetings/parties?	Yes No
Signature(s) (required): ______________________________________________________

Please do not send cash.
Make checks payable and mail to:

Family Synergy
P.O. Box 3073
Huntington Beach, CA 92605-3073

Thank You
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