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ASSOCIATE MEMBERSHIP APPLICATION
Frederick Allen Elks Lodge #609
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First Name
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Last Name
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Email
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Additional Name (Couples Membership)
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Mailing Address
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Phone Number
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Type of Membership
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Temporary Day Pass - Individual: $5 (allows entry for the day or the event)
Annual Membership - Individual: $60 (expires 12 months to the day after joining
Annual Membership - Couples: $100 (expires 12 months to the day after joining)
Other:
Today's Date (begins Annual Membership Term)
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Amount Paid:
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Form of Payment
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Submission:
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In-person Lodge Ambassador:
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If paying by check, please ...
Make payable to: Frederick Allen Lodge #609
Add to Memo: Associate Membership
Mail to: 69 Beekman Street, Saratoga Springs, NY 12866
NOTE: Annual Date will begin on date that application is submitted.
We are delighted that you are interested in joining our circle at the historic Frederick Allen Elks Lodge #609! An Elk Brother or Lodge Daughter will be in touch with you shortly about possible acceptance of your application. Thank you.
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