MACK SKI CLUB MEMBERSHIP APPLICATION
NAME _______________________________________________
ADDRESS ____________________________________________
CITY ________________________________________________
STATE ________________ ZIP __________________________
PHONE ______________________________________________
EMAIL _______________________________________________
NEW MEMBER SINGLE 20
NEW MEMBER FAMILY 30
STUDENT MEMBERSHIP 14
NEW MEMBER 65+ 12
NEW MEMBER FAMILY 65+ 17
RENEWAL SINGLE MEMBERSHIP 17
RENEWAL FAMILY MEMBERSHIP 22
RENEWAL STUDENT 12
SENIOR RENEWAL SINGLE MEMBERSHIP 65+ 8
SENIOR RENEWAL FAMILY 65+ 10.50
MAKE CHECKS PAYABLE TO "MACK SKI CLUB" TOTAL AMOUNT PAID _________________
MAIL TO: Email for Information: tlblack1981@yahoo.com
Terry Blackman Phone: 610-554-9886
1246 S 10th Street
Emmaus Pa 18049
Membership Cards can be picked up at a meeting or membership cards can be mailed out only if your application is received with a self-addressed stamped envelope. Dues will not be accepted with a trip payment.
