Atlanta Flames Fan Club
Membership Application Form 2015-2016
Return completed form to:
Atlanta Flames Fan Club
c/o Betsy Watkins
3297 Wiltshire Dr.
Avondale Estates, GA. 30002
Phone: 404-294-5714
Our Name
We continue to use the name, Atlanta Flames Fan Club, so we may remain as members of the National Hockey
League Booster Clubs, Inc. The NHLBC has members throughout the United States, Canada and many other
parts of the world. On the second weekend of August all the booster clubs gather together for the national
convention. The remainder of the year the clubs exchange newsletters and visit together on various road trips.
Our Purpose
Our purpose is to support the sport of ice hockey in Atlanta and throughout the Southeast.
Types of Membership Available
[ ]
Regular
$10
-
Single, adult residing in Georgia
[ ]
Family                 $16
- Married couple with or without children residing in Georgia
[ ]
Junior
$5
-
Under 18 years-of-age
[ ]
Non-Resident
$8
- A
nyone residing outside of Georgia
[ ]
RENEWAL
[ ]
NEW
Name : ___________________________________________
Birthday : _____________________
Month and day only
Address: __________________________________________
Apt. ___________
City: ______________________________ State: _________
Zip: ___________
Occupation: _______________________________________
Employer: ________________________________________
E-mail address: __________________
Telephone: __________________
____________________
_______________________________
HOME
OFFICE
If  Family membership - list names, birthdates of all members :
Spouse: ________________________________________
Birthday : _____________________
Name:
________________________________________
Birthday : _____________________
Name:
________________________________________
Birthday : _____________________
Name:
________________________________________
Birthday : _____________________
Name:
________________________________________
Birthday : _____________________