Harmony Kingdom/HK House of Peers - Independent Club Application

(The House of Lords is the second chamber of the British Houses of
Parliament. Members of the House of Lords are known as 'peers.')

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HK HOUSE OF PEERS - INDEPENDENT CLUB APPLICATION

Harmony Kingdom
Authorized Independent Club Application

Revised: August 12, 1999

Purpose:

Our independent club purpose is based on Harmony Kingdom, education and fun:

_____Yes _____ No

Independent Club Identification:

Independent Club Name:	___________________________________
Independent Club Address:	___________________________________
	___________________________________
	___________________________________

Independent Club Officers and Contact Information:

President:

________________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

Vice President:

___________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

Secretary:

_______________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

Treasurer:

_______________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

The House of Peers Delegate will receive communications from HOP and Harmony Kingdom as well as additional duties and responsibilities. This Delegate may be an existing officer.

HOP Delegate:

____________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

An alternate HOP Delegate should be selected. This alternate will receive all notices as sent to the HOP Delegate and acts only in the absence of the HOP Delegate.

Alternate HOP Delegate:

___________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

Other Positions: (include Newsletter Editor, Membership Chairman, etc.) Use additional sheets as necessary.

Position:

_________________________________________________

Name:

___________________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

Day Phone:

____________________

Eve Phone:

____________________

E-mail Address:

____________________________________________

Independent Club donations from Harmony Kingdom should be mailed to the following address:

Name:

____________________________________________________

Address:

__________________________________________________

City, State, Zip:

____________________________________________

E-mail Address:

____________________________________________

Memberships and Meetings:

Our club will adhere to the [Harmony Kingdom Authorized Independent Club Guidelines]:

_____Yes _____ No

Our club will hold at least four (4) meetings a year:

_____Yes _____ No

We will maintain a minimum membership of twenty-five (25) members:

_____Yes _____ No

Mission Statement:

Our independent club mission statement is:

______________________

___________________________________________________________

Charity:

Our independent club has selected a charity to support:

_____Yes _____ No

Our independent club supports the following charity:

_______________

___________________________________________________________

Newsletter:

Our independent club produces a newsletter:

_____Yes _____ No

The name of our newsletter is:

________________________________

And is published: _____ Monthly _____ Bi-Monthly _____ Quarterly

Newsletter copies will be automatically forwarded to Harmony Ball Company (Attn: Marketing Department), 232 Neilston Street, Columbus, OH 43215:

_____Yes _____ No

Trademarks and Copyright Rules:

Our independent club will abide by all Harmony Kingdom trademark and copyright rules:

_____Yes _____ No

Bylaws:

Our independent club has adopted bylaws:

_____Yes _____ No

A copy will be forwarded to the HK House of Peers (Attn: HOP Secretary), 4532 Shoal Creek Court, Alexandria, VA 22312:

_____ Yes _____ No

Other:

Our local chapter is interested in the following:

_____ Having a speaker attend a meeting

_____ Participating in a National Convention

_____ Assisting at a tradeshow

_____ Please list other ideas:

__________________________________

___________________________________________________________

We have supplied and reviewed the following information and verify that it is correct and true.

_________________________________
President

____________________
Date

Harmony Kingdom Authorized Independent Club Application:	Authorized / Rescinded
_________________________________ Harmony Kingdom Representative	____________________ Date

All applicants will be notified by Harmony Kingdom within three (3) weeks from receipt of completed application, if approved or denied company authorized independent club status.

Please submit application to:

HK HOUSE OF PEERS
HOP SECRETARY
4532 SHOAL CREEK CT
ALEXANDRIA VA 22312-3166

Print and complete the above Application,
or request an application by mail from:
HK HOUSE OF PEERS, 4532 SHOAL CREEK CT, ALEXANDRIA VA 22312-3166

[Harmony Kingdom Authorized Independent Club Guidelines]
[Harmony Kingdom Authorized Independent Club Application -
Notice of Intent]

HK House of Peers - Member Club
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Please request permission using the e-mail address below.
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