PNNC Membership Form
2017-2018

Please complete and return this form, together with $40 (annual dues) via a check payable to PNNC or PayPal (piedmontpnnc@gmail.com) payment confirmation, to: 

Gael Tornatore
62 La Salle Avenue
Piedmont, CA 94611

Please include information for your spouse or partner, if applicable. Please email gogael@gmail.com and/or piedmontpnnc@gmail.com with any questions.


Name(s):                                                                                                   Date:



Address (please include zip code): 



Telephone Number(s) (home + mobile (both spouses if applicable)):



Email Address(es) (both spouses if applicable): 



Children’s names and birthdays: 


How did you hear about the PNNC?:


The success of the PNNC is due entirely to the involvement of our members. Please check if you are interested in:


_______ Becoming a board member
_______ Hosting a social event in your home
_______ Delivering a meal for a family with a new baby or serious illness
_______ Helping to plan, set up, or clean up one of our events
_______ Attending our weekly Coffee & Playgroups
_______ Joining one of our monthly book groups 
_______ Joining a Supper Club

The sole purpose of the PNNC Membership Directory is to enable social communication between the club & its members. 
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PNNC Admin,
Feb 13, 2017, 8:49 PM