Funclub App

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
(Picture Identification Required)

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: