| Instructions
Fill out the form below completely, then using your browser’s File|Print menu option, print the form. Bring it to the Fun Club booth at Oneida Bingo & Casino and join the club! FUN CLUB APPLICATION & ENROLLMENT FORM |
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| Today’s Date: | Wednesday February 12, 2003 | ||
| Last Name: | |||
| First Name: | Middle Initial: | ||
| Address: | |||
| City: | State: | ||
| County: | Zip: | ||
| Home phone number with area code: | |||
| Email address: | Would you like mail? | Yes No | |
| Birth Date: | |||
| Driver’s License Number: | |||
| Wedding Anniversary: | |||
| Social Security Number: | |||
| Spouse’s Name: | |||