MEMBERSHIP APPLICATION
Standard Membership ……………………………… $55.00 per year
Senior Membership (62 years and older) ....…… $45.00 per year
Life Membership ……………………………… $1,000.00
Benefactor ……………………………………… $200.00 per year
Patron ……………………………………………… $150.00 per year
Group Membership ……………………………… $100.00 per year
Sponsor ……………………………………… $75.00 per year
Please print this application, fill out the information and send in to:
The Arc of Oakland County, Inc.
ATTN: Web Membership
Processing
1641
W. Big
(Phone
#
Name: _______________________________
Address: _________________________
City _________________________
Zip _______________________________
Telephone: _________________________
Select Payment: Check Make check payable to: The Arc of Oakland County
Credit card VISA MASTERCARD
Credit card No.: _______________________________
Credit card billing address if different from above: ______________________________________
____________________________________________________________________________
Expiration date as it appears on credit card: ___________________________________________
Signature of card holder: _________________________________________________________
THANK
YOU! The amount of your membership is tax deductible to the
extent provided by law.