Date: ____________

Name: ___________________________________________   Home Phone: _________

             last               first                middle            title

Employer: ______________________________________________________________

Mailing Address: _________________________________________________________


Business Phone: _____________  Fax: ___________   E-mail Address: _____________

Please check (P) one: 

q New Member           q Renewal          Initial Membership Year: _______

If you are not already a committee member, please seriously consider sharing a little of your time, talents, and skills by serving one or more of the committees listed below. Indicate your preference by placing a check in the appropriate box.

q TLG Newsletter q Mentoring  q Program
q Membership q Awards  q Policy, Planning & Research
q Constitution & By-Laws

TLG Annual Dues: The TLG membership year is January 1 to December 31. The fiscal year is the same. The dues structure is as shown below. Please indicate your category by placing a check in the appropriate box and remit a check in the correct amount. Make checks payable to "The Thursday Luncheon Group." Retired members may pay the rate for their grade at retirement. 

q $25.00: FS-04 and below; GS-11 and below  q

$50.00: FS-01, Senior Executive Service, Senior Foreign Service  and Ambassador level members

q $30.00: GS-12 - 14, and FS-3 and FS-2 q $500.00:  Lifetime 


Membership Committee (TLG)

           P.O. Box 1106

     Washington, DC 20013


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