Member Application

Click Here to Download Printable Membership Application Form (Check, Visa, Mastercard, or Discover

Or you can fill out the form below (Checks only)

Silver Swallows Alumni Registration Form
First Name
 Middle Name or Initial
 Last Name
Spouse’s Name
 Maiden Name
Address
City
 State

 Zip Code

 Zip Plus Four
E-Mail

 Phone
 Cell Phone
Pick One
I was an Ozark employee
I am a relative of an employee
I was a 1950-1986 Associate of Ozark 		Date Hired
mm / dd / yyyy
 Date Retired/Left Ozark
mm / dd / yyyy
Ozark Department or Association
 Title
Secondary Address
Secondary City
 State

 Zip Code

 Zip Plus Four
Secondary Phone
 Effective From Date
mm / dd / yyyy
 Effective to Date
mm / dd / yyyy
Tell Us About Yourself
The Silver Swallows Alumni newsletter is the glue and one of the largest contributing factor in keeping our Ozark family together. We ask that you please complete this section of the form. Here are just some of the many subjects that you may want to consider. Are you still working? If so, where? When are you planning to retire? When did you retire? Any Health problems? Loss of loved one that you wish to share? Relocations? Significant birthdays? Marriage? Do you live in different locations during different seasons? Did you attend any schools during the last year? Did you take a vacation last year? If you have a hobby, tell us about it. Do you own a business? Do you volunteer your time? Do you hold an elected office? How do you keep yourself physically fit? What do you do to keep yourself busy? What do you remember about Ozark? Tell us about some of your fond memories at Ozark. Any funny Ozark stories? If you have anything else of interest, tell us about it.
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Members Only Website Membership Directory Approval

The Privacy Act requires the organization to have a password protected website program allowing
“Members Only” to have access to the web site’s membership address roster. Only members in “Good Standing” (dues paid) and have agreed to the following terms will have access rights to the “Members Only” section of the website. This information will not be sold, rented or shared.

By selecting “I Agree” below, I authorize Ozark Silver Swallows, Inc. to include the above information on the Private “Members Only” Membership Address Directory page of the www.silverswallows.com website AND, I further agree not to let the membership names, addresses, phone numbers and e-mail address roster be used for business, charitable, political or any other purpose by me, my relatives or friends.

I Agree
I Do Not Agree		 I have read and understand the conditions above and authorize the sharing of my data. I agree not to share another member’s data. Selecting “I Agree” constitutes an e-signature on my part.
Date of Authorization
mm / dd / yyyy