Single Gourmet Long Island - Social Dining Club

Congratulations! You are only seconds away from joining in the spirit of Fun, Friendship and Fine Dining! Welcome to fun filled evenings with other interesting, intelligent singles who like good food, wine and stimulating conversations!

Your annual membership fee is $85.00. Our online application payment process is completely safe and secure.

Your other options include:

1.	Charging by phone, please call (516) 897-8448
2.	Paying by check, made out to The Single Gourmet of Long Island, along with a completed copy of this form to Single Gourmet of Long Island, 248 West Park Avenue, Suite 208, Long Beach, NY 11561.

Step 1: Join online today! Fill out the form below. Then hit the "Send Now" button. After hitting the "Send Now" button you will be taken to a page where you can complete your payment process online quickly, safely, and securely using a credit card!
ALREADY A MEMBER? CLICK HERE TO RENEW YOUR MEMBERSHIP! (Use the same Username/Password that allows you access to the Events Page)

Name

Address

Address2

City

State/Province

Zip/Postal Code

Daytime Telephone

Evening Telephone

Cell (Optional):

Facsimile

E-mail

Gender:

Male Female

Profession:

Age Range:

20's
30-35
36-40
41-45
46-50
51-55
56-60
Over 60

How will you be paying for your membership?

	I will be paying online using my credit card
	I will be mailing you a check
	I will call you with my payment information.
	You may call me for my payment information using the phone number I have provided

How did you hear about the Single Gourmet of Long Island?

Address:	248 West Park Avenue Suite 208 Long Beach, NY 11561
	248 West Park Avenue Suite 208 Long Beach, NY 11561
Phone:	(516) 897-8448
E-mail:	info@SingleGourmet.org

ALREADY A MEMBER? CLICK HERE TO RENEW YOUR MEMBERSHIP! (**Use the same Username/Password that allows you access to the Events Page**)

ALREADY A MEMBER? CLICK HERE TO RENEW YOUR MEMBERSHIP!
(Use the same Username/Password that allows you access to the Events Page)