Please Print this application and mail with your contribution.
Name: Maiden Name: Address: City, State, Zip: Maiden Name: Phone Number: E-mail Address: Years you were at camp: Please check your choice:
Please check your choice:
[_] I love camp but I'm a poor college student Dues = $25.00 - Thank You! [_] Minimum Dues = $40.00 - Thank You! [_] Dues + Additional Contribution = $75.00 - Thank You! [_] Generous Dues: $100.00 [_] Camp Really Made an Impression on My Life Dues: $200.00 [_] Other: $ ______________ Thank You!
[_] I love camp but I'm a poor college student Dues = $25.00 - Thank You!
[_] Minimum Dues = $40.00 - Thank You! [_] Dues + Additional Contribution = $75.00 - Thank You!
[_] Generous Dues: $100.00
[_] Camp Really Made an Impression on My Life Dues: $200.00
[_] Other: $ ______________ Thank You!
Camp Eberhart Alumni Association, Inc. 316 South Eddy Street South Bend, IN 46617