New or Renewing Member *

New

Renewal

Membership Category *

Full Membership is open to all individuals employed full or part-time in activities in a geriatric setting; such as a consultant, coordinator, director, assistant, etc. Associate Membership is open to those with an interest in MACS but do not meet the criteria for full membership. This includes volunteers, businesses, students and retired activity coordinator professionals. Associate members may not vote or hold office.

Full Membership ($50)

Associate Membership ($40)

Region *

Please select the region you live in.

Eastern (Baltimore City, Prince George's, Charles, St. Mary's, Calvert, Anne Arundel, Baltimore, Harford, Cecil, Kent, Queen Anne's, Talbot, Caroline, Dorchester, Wicomico, Somerset & Worcester counties.)

Western (Garrett, Allegany, Washington, Frederick, Carroll, Howard & Montgomery Counties)

Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Mobile Phone

(###)

###

####

Work Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Work Phone

(###)

###

####

I prefer to be contacted via the following email address I've provided *

Personal

Work

Both