BHEC Alumni Association Enrollment Form

_____ Kindly enroll me as a member of the BHEC Alumni Association.

_____ Kindly renew my membership in the BHEC Alumni Association.
I am enclosing a check for:

______ One Year's Dues $18.
______ Family Dues $30.
______ Lifetime Membership $150.
______ Lifetime Family Membership $250.

 Please make your check payable to:
BHEC Alumni Association
Name __________________________________________________

Address ________________________________________________

________________________________________________________

City ___________________________ State _____ Zip ________

E-Mail Address __________________________________________		 Mail to:

BHEC Alumni Association
Berkshire Hills Emanuel Camps
547 Saw Mill River Road, Suite 3D
Ardsley, NY 10502