1. Atlanta Flames Fan Club
Membership Application Form 2013-2014
Return completed form to: Atlanta Flames Fan Club
c/o Betsy Watkins
3297 Wiltshire Dr.
Avondale Estates, GA. 30002
Phone: 404-294-5714
Our Name
We continue to use the name, Atlanta Flames Fan Club, so we may remain as members of the National Hockey
League Booster Clubs, Inc. The NHLBC has members throughout the United States, Canada and many other
parts of the world. On the second weekend of August all the booster clubs gather together for the national
convention. The remainder of the year the clubs exchange newsletters and visit together on various road trips.
Our Purpose
Our purpose is to support the sport of ice hockey in Atlanta and throughout the Southeast.
Types of Membership Available
[ ] Regular $10 - Single, adult residing in Georgia
[ ] Family $16 - Married couple with or without children residing in Georgia
[ ] Junior $5 - Under 18 years-of-age
[ ] Non-Resident $8 - Anyone residing outside of Georgia
[ ] RENEWAL [ ] NEW
Name : ___________________________________________ Birthday : _____________________
Month and day only
Address: __________________________________________ Apt. ___________
City: ______________________________ State: _________ Zip: ___________
Occupation: _______________________________________
Employer: ________________________________________ E-mail address: __________________
Telephone: __________________ ____________________ _______________________________
HOME OFFICE
If Family membership - list names, birthdates of all members :
Spouse: ________________________________________ Birthday : _____________________
Name: ________________________________________ Birthday : _____________________
Name: ________________________________________ Birthday : _____________________
Name: ________________________________________ Birthday : _____________________
Name: ________________________________________ Birthday : _____________________