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:                                                                   Scan Membership and email to:   TBD

GAIL EICHELBERGER
756 DELONG ROAD
ALBURTIS, PA 18011