Camp Eberhart Alumni Association
316 S. Eddy St. • South Bend, IN 46617 • 574.234.0069 • FAX 574.234.6414

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Membership Application - 2010

Please print this application and mail with your contribution.

Name:

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Maiden Name:

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Address:

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City, State, Zip:

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Maiden Name:

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Phone Number:

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E-mail Address:

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Years you were at camp:

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Please check your choice:

[_] Student Dues = $25.00

[_] 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 So Very Much!

Send your contribution to:

Camp Eberhart Alumni Association, Inc.
316 South Eddy Street
South Bend, IN 46617

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Thank you for joining the Camp Eberhart Alumni Association!