CHIC Application Form

Complete and mail to PO Box 17850, Long Beach, CA 90807



Date:       _______________

Femme Name: __________________________________________________ Age: ________

Mailing Name: ________________________________________________ Phone: ____-____-________

Mailing Address: ______________________________________________

City: ________________________________________  State: CA  Zip: _____________

Special Instructions for contacting you: ____________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Number of years you have been crossdressing?: ______

Does your family know of your crossdressing?: ______

Where did you learn about CHIC?:____________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Do you know any CHIC members?: ______

If "Yes", list their Femme Names?: ____________________________________________

_____________________________________________________________________________

Describe the extent of your crossdressing( frequency, types of clothing, etc.): 

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________


Have you ever been a member of another CD organization?:  _______

Name of Organization ____________________________________________


What talent or ability do you posses that you would be willing to contribute to 
CHIC?: (use additional sheets as  required)

_____________________________________________________________________________

_____________________________________________________________________________


What do you expect to gain from CHIC?:  _____________________________________

_____________________________________________________________________________

_____________________________________________________________________________

All responses to this questionnaire are held in strictest confidence. 
This application will be used to evaluate your compatibility with our members 
and will be returned to you upon completion of membership processing.