Chugiak-Eagle River Senior Center
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Chugiak-Eagle River Senior Center |
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YOU DON'T HAVE TO BE A SENIOR TO BE A MEMBER! |
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Application for Membership |
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Chugiak Senior Citizens, Inc., 22424 N. Birchwood Loop, Chugiak AK 99567 (907) 688-2677 |
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Sign me up as a VOTING* ASSOCIATE* member. |
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Enclosed is my membership fee in the amount of: $20.00 for individual membership ($30.00 for a couple). |
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I'd like to become a Lifetime Member. Enclosed is my one-time membership fee of $125.00. |
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Please sign us up as a Business Member. Enclosed is payment of $25.00 |
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Name: ____________________________________________ Birth date: _________________ | |
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Residence Address: (city/state) ____________________________________________________ | |
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Home Phone: ____________________ Work Phone: _____________________ | |
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Mailing address: ______________________________________________________________ | |
| *To be a voting member you must be 55 or over; associate members are under 55. | |
Return your membership form with remittance to: | |
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Chugiak-Eagle River Senior Center |
Phone: (907) 688-2677 |