Michigan City High School

MICHIGAN CITY HIGH SCHOOL

ATHLETIC BOOSTER CLUB, INC.

APPLICATION FOR MEMBERSHIP 2010-2011

Name: ______

Address: ______

City, State, Zip: ______

Phone: ______email address: ______

I wish to become an Athletic Booster for the 2010-2011 year – membership entitles the cardholder and corresponding family member to discounts at over 20 local merchants.

As an added benefit, Wolves Athletic Booster can become part of the Gordon Food Service Fun Funds program. See the application for further information. Please check box and complete the application.

Regular Membership $20.00 (Membership is limited to those 18 years+) $______

Name for second card: ______

Senior Membership $15.00 (65+) $______

Name for second card: ______

I wish to make a donation to the Scholarship Fund in this amount. $______

I wish to make additional donation to the Booster Club. $______

Total Payment $______

On behalf of the MCHS athletes who will benefit from the use of these funds, we sincerely thank you. Please return this form in the mail to:

MCHS Athletic Booster Club, Inc.

8466 W. Pahs Road (One Wolf Trail)

Michigan City, IN 46360

Make your check payable to: MCHS Athletic Booster Club, Inc.