The San Antonio Parrot Head Club is a non-profit organization whose purposes are to provide means of interaction for people interested in Jimmy Buffett music and tropical lifestyle and to assist the community in charitable and environmental activities.

(1)Must have an interest in Jimmy Buffett’s music (2)Must have an interest in charitable and community services and enviromental concerns (3)Pay dues

Enclose this application with your check made out to SAPHC and mail to:

SAPHC 8458 Oak Thicket Lane San Antonio, Texas 78255

E-mail address: SAPHClub@aol.com

Please PRINT CLEARLY!

Name:______________________________________________Birthday:_____________________

Address:_________________________________________________________________________

City:__________________________________State:_______________Zip:___________________

Home Phone:__________________ Work Phones:(his)_________________(hers)______________

Fax:______________________________ E-mail Address:_________________________________

Spouse’s Name:_______________________________________Birthday:_____________________

(Ladies may omit year)

Occupation:( his)_______________________________(her)________________________________

Kid’s/Parakeet’s Name(s) & Birthdays:___________________________________________________

Favorite Jimmy Buffett Song:_______________________________CD:_______________________

I would be interested in assisting in the following activities:

_____Newsletter _____Community & Charitable activities

_____Hosting parties or events _____Social event planning

_____Phone Committee _____Soliciting merchant support

_____Fund raising _____Membership

Do you have any talents or other resources that may help the club? If so, please explain:

______________________________________________________________________________________

______________________________________________________________________________________

How did you hear about the club?___________________________________________________________

Is it OK to print your name, address and phone number for the purpose of a member directory ? Yes / No

Annual dues are $30 per individual membership. Or include your spouse for an additional $10. Membership renewals will be due on your membership anniversary date.

Type of membership:(Circle one) Individual Membership $30* Spousal Membership $40*

*This contribution is not deductible as a charitable contribution for federal income tax purposes.

Since Parrot Heads are known to enjoy a cold one, we heartily support using a designated driver.