PO Box 0473  Clinton, Maryland 20735-0473

MACS Membership Application for Fiscal 2007-2008

Membership dues are paid annual on the anniversary date when first paid. Please make checks payable to: Maryland Activity Coordinators Society, Inc.  and mail to the above address. All mailings go to your home address.  Membership belongs to you, not the facility.  Please print or type clearly and complete the entire application.

___New    ___Renewal   Circle your region    Region (see list below):  I  II  III   IV   Date:__/__/__

Name _______________________                            Home Phone (___)___ -_____

Home Mailing Address _________________________________________________________

E-Mail Address ____________________________

County ________________ Title/Position ________________                 

Facility  Address _____________________________________________

Work Phone (___)____-_____          Fax (____)_____-_______     Work E-Mail   ___________________

Enclosed is check for:   ____ Full Membership ($45.00)   ____ Associate Membership ($35.00)
*There will be a $25.00 charge for all returned checks. (Fee Subject to Change)

Would you be interested in serving on a committee? ____ Yes ____No

If you are new to MACS please tell us how you heard about our organization:
__ Membership Brochure    __ MACS Region Workshop  __ MACS State Conference
__Workshop/Seminar     __ Activity Professional    __ Facility Administrator  ______________Other

Region I: Cecil, Kent, Queen Anne, Talbot, Caroline, Dorchester, Wicomico, Somerset, Worcester
Region II: Anne Arundel, Baltimore County, Baltimore City, Carroll, Harford, Howard
Region III: Montgomery, Prince George's, Calvert, Charles, St. Mary's
Region IV: Allegany, Frederick, Garrett, Washington