Become a Club Member

Please complete the form below to become a member of the Italo American Club of Rhode Island.

Name*
First Last
Email*
Enter Email Confirm Email
Date of Birth*
MM slash DD slash YYYY
Phone*
Address*
Street Address City State ZIP Code
Type of Membership*
- Voting Membership $40/month
- Associate Membership $30/month
Are you of Italian descent?
- Yes
- No
Father's Name
Mother's Maiden Name
Occupation, Employer and/or Business
Business Address
Street Address City State / Province / Region ZIP / Postal Code Country
Business Phone
Have you ever been convicted of a crime?*
- Yes
- No
Please provide details below:
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Note
Upon review of your submission, we will email you an electronic copy of our application for you to complete and return.
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George Lazzareschi, Jr., President

Thomas Norato, Vice President

Robert Villucci, Treasurer

Donna M. Folcarelli, Secretary

Phone:
401.621.5600

Fax:
401.621.9950

477 Broadway
Providence, RI 02909

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