Camp Eberhart Alumni Association
 316 S. Eddy St. • South Bend, IN 46617 • 574.234.0069 • FAX 574.234.6414
Membership Application - 2009

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:
[_] 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!

Send your contribution to:
Camp Eberhart Alumni Association, Inc.
316 South Eddy Street
South Bend, IN 46617
Thank you for joining the Camp Eberhart Alumni Association!