Membership
Application
Date: __________
Fem Name
(First and Last):____________________________________Age:_______
Mailing
name:
__________________________________________________________
Mailing
address:
State: ____ Zip:_________ Phone: ( ) ________ E-mail:_____________________
Special
instructions for contacting you:
____________________________________
_______________________________________________________________________
Sexual
Orientation: Hetero:_____ Gay:
_____ Bi: _____
Are you
married? ______ How long ?______ Does wife know?________________
Do you
have children? _____ How many?____________
Ages? _______________
Does your
family know? _____ Are they accepting? ________________________
How long
you have been crossdressing? ____ At what age did you start?______
How did
you learn of
Do you
know any
_______________________________________________________________________
Describe
the extent of your crossdressing such as frequency, items of
clothing etc. ___________________________________________________________________
_______________________________________________________________________
Do you
go out in public while dressed?______ Where?________________________
_______________________________________________________________________
Have you
ever belonged to another crossdresssing organization?______________
Organization
name:__________________________ When?____________________
Describe
any outside hobbies or interests you have away from crossdressing:
_______________________________________________________________________
How do
you feel CHIC will benefit from your
being a member? _______________
_______________________________________________________________________
_______________________________________________________________________
What do you
expect to gain from being a member of
_______________________________________________________________________
_______________________________________________________________________
Signed _______________________