Membership Application

Membership Details
New or Renewing Member *
Membership Category *
Full Membership is open to all individuals employed full or part-time in activities in a geriatric setting; such as a consultant, coordinator, director, assistant, etc. Associate Membership is open to those with an interest in MACS but do not meet the criteria for full membership. This includes volunteers, businesses, students and retired activity coordinator professionals. Associate members may not vote or hold office.
Region *
Please select the region you live in.
Member Details
Name *
Name
Home details
Home Address *
Home Address
Home Phone
Home Phone
Mobile Phone
Mobile Phone
Workplace Details
Work Address
Work Address
Work Phone
Work Phone
Contact Preferences
I prefer to be contacted via the following email address I've provided *