CAREEA Membership Form

 

Name____________________________________________________________________

 

Address__________________________________________________________________

 

City _____________________________  State ________  Zip __  __  __  __  __

 

Email ____________________________________ Phone _________________________

 

District retired from and year ________________________________________________

 

Please write alternate address (summer or winter) including dates.

 

Send your $5.00 (per year) check payable to CAREEA.  Mail it to Connie Knowlton, CAREEA Treasurer, 4017 Alpha Street, Lansing, MI  48910-4721.  Please check years for which dues are being paid:

 

            2006-07 ______         2007-08 ______        2008-09_______