ADULT Farmington / Farmington Hills Optimists
Breakfast Club
Membership Application / Dues Payment Form

Optimist International

An OPTIMIST CLUB is a voluntary organization of civic-minded men and women banded together for progressive thought and action in community service. Membership, which is by invitation only, is composed of citizens drawn from business, industry, agriculture and the professions. Members are motivated by the desire to contribute to the community from which they and their families draw daily benefits. There is no greater opportunity for participation in community affairs and service than in an Optimist Club.

The purposes of the Optimist club are to develop Optimism as a philosophy of life; to promote an active interest in good government and civic affairs; to inspire respect for the law; to promote patriotism and work for international accord and friendship among all people; to aid and encourage the development of youth, instill belief that the giving of one's self in service to others will advance the well-being of man, his community and world.

Member Application OR Dues Payment ONLY(*)

Please select Member Application OR Member Dues Payment ONLY

Member Information:

First Name(*)

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Middle Name of Initial

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Last Name(*)

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Home Address(*)

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Second Line Home Address

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Home Address City(*)

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Home Phone Number

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Home Address State(*)

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Home FAX Number

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Home Address Zip Code(*)

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Personal Cell Phone Number

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Personal Email Address(*)

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Date of Birth

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Spouse's Full Name

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Place of Birth

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Spouse's Date of Birth

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Number of Years in Community

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Wedding Anniversary Date

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Business Information:

Company or Business Name

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Type of Company or Business

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Business Address

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Second Line Business Address

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Business Address City

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Business Address State

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Business Address Zip Code

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Business Phone Number

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Position with Business or Job Title

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Business Email

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Number of Years with Firm

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Member Interest Finder:

Indicate your degree of Interest using the following notation:
H = High M = Moderate L = Low 0 = None

Greater satisfaction and benefit come from the participation in club activities through committee membership. Assignments may be based upon your interest and committee openings.

COMMUNITY SERVICE