Please PAY REINSTATEMENT DUES and fill out the the membership form below: Blue Goose Michigan Pond - Reinstatement Form Blue Goose Michigan Pond - Reinstatement Form Fill out this form if you are a lapsed Blue Goose member, and want to join again. Name * Date of Birth * Mailing Address * City * Zip or Postal Code * Email Address * Residential Phone Number / Cell Phone Number * Business Phone Number Employed by: * Spouse Name Where were you a pond member? * IF YOU HAVE EVER BEEN A POND OFFICER COMPLETE THE FOLLOWING: Position Held - Dates Position Held Do you agree to our acceptance policy? * Agree Acceptance of application by Grand Nest is based on acceptance of Pond and vouched for by 3 Ganders. Entertaining a high regard for the aims and objects of the Honorable Order of the Blue Goose, International and promising to abide by the Constitution and By-Laws, if admitted to membership, I hereby submit my application for membership. Δ