Académique Documents
Professionnel Documents
Culture Documents
I/We desire to become members of the Maryland Athletic Club and hereby provide
the following information as part of our application:
Date: _____________________________
Membership Information
Membership Begins:______________________________
Mailing Address:_______________________________________________________
Initial Fee:_____________________________________
Pro Rated Dues Collected Today:__________________
Employers Name:_____________________________________________________
Sub-Total:______________________________________
Buyers Signature
Date
I /We (Member/Sponsor) hereby authorize the Club to effect payment for monthly dues, along with authorized member charges, to be
collected electronically on or after the 2nd or 15th (circle one) of the month, unless previously paid by other means. This authorization
is to remain in full effect until Club has received WRITTEN NOTIFICATION from me per Section 5. on the reverse side.
Member
Date