The Clan MacRae Society of North America
Application for Membership

Instructions

Complete this form and mail it along with your check to:

The Clan MacRae Society of North America
306 Surrey Road
Savannah, GA 31410-4407

Make your check payable to:

Clan MacRae of NA

Applicant Information

Full name:	____________________________________________________
Street address:	____________________________________________________ ____________________________________________________
City:	____________________________________ State:___________
Postal code or Zip+4:	______________________ Phone: ________________________
E-mail:	____________________________________________________

Qualifications

If your name does not show the basis for membership, please explain your MacRae connection. For example, "My maternal grandmother was Mary MacRae.":

______________________________________________________________________________
______________________________________________________________________________

Membership Type

Please check the membership level.

	Membership Level	Yearly Dues
___	Individual/Family Membership*	$25.00
___	Student (under age 21)	$15.00
___	Patron	$100.00 or more
___	Lifetime*: up to age 61	$500.00
___	Lifetime*: age 62 and over	$300.00

Interests

Please check the areas in which you have an interest:

___	Clan MacRae social activities	___	Fundraising
___	Attendance at Highland Games	___	News of other MacRaes
___	Genealogy	___	Highland music, literature, etc.
___	Other. Please specify: _________________________________________________________