Membership Form

 
Membership period from
July 1, 2008 through June 30, 2009

Please complete this form, print the results page, and mail it with a check to the address on that page.  You will be contacted with additional information.

Name(s): 
Street:
City:
Zip Code:
E-mail Address:
Phone (000-000-0000):
Birth date (MM/DD/YY):    First Name:   
Birth date (MM/DD/YY):    First Name:   
Dues: $50 for individual, $90 for a couple
After February 1, fee is pro-rated to $20/each (through June 30)
Snowbird rate:  $35 for the partial year which includes the months April through December

Do you have a special interest you would be interested in presenting as a class/learning experience?

Yes No

Please specify: 

Are you  willing to help coordinate a class?  This involves communicating with the instructor, telephoning, and helping at the time of the class.

Yes No

 

Alpena Volunteer Center
ACC Center Bldg. Room 108
665 Johnson St.
Alpena, MI 49707
Phone:  (989) 358-7271
Toll-Free:  888-468-6222 ext. 7271
Fax:  (989) 358-7554
E-mail:  bruskik@alpenacc.edu
      Information is current up to 05/23/2008