Bacio Inc - Bridgeport Area Cultural Italian Organization

Benvenuto a
BACIO INC. of CONNECTICUT
Bridgeport Area Cultural Italian Organization

Bacio Membership Application - $60 per year
To apply using this web form:
Please fill out the application below, and click submit. Make your check payable to BACIO and mail to:
BACIO
19 Old Sport Hill Rd.
Easton, CT 06612

To apply using standard mail:
Print the application here , fill out and and mail to the above address along with your check.

Family Name *
Father's name and date of birth*
Mother's name and date of birth*
Children living in your home and date of birth*
Street	City
State	Zip
Home Phone	Business Phone
Fax	Email (required)
Cell Phone
What kind of work did/do you do?	Province or town in Italy from which you or your parents/grandparents originate
Suggestions of type of programs you would urge BACIO to conduct	Check Date and Check Number

*Our only interest in your age is to consider whether you are able to take on a responsibility for BACIO. We would not want
to impose on our most senior senior citizens.

Thank you for your interest in BACIO! Please feel free to contact Leonard Paoletta for more information.

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