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*

Street

City

State

Zip

Business Phone

Fax

Cell Phone

Email (required)

Home Phone

What kind of work did/do you do?

Suggestions of type of programs you would urge BACIO to conduct

Province or town in Italy from which you or your parents/grandparents originate

Check Date and Check Number

Children living in your home and date of birth*