Membership Form

Please fill out the form and mail to the address shown below:

The Southeastern Climbers Coalition
943 Stokeswood Ave SE
Atlanta, Georgia 30316

Name:______________________________________________________________

Address:____________________________________________________________

Address:____________________________________________________________

City:________________________________  State:_______  Zip______________

Phone: _________________________  E-mail_____________________________

Skills:______________________________________________________________

Donation: (all contributions include an SCC sticker)

$10 - SCC T-Shirt only (no membership)   Qty: ___

T-Shirt Size: ___

 

$25 - Belayer Annual Membership (card, no T-shirt)

$35 - Flash Annual Membership (SCC T-shirt and card)

 

T-Shirt Size:_______

 

$50 - Lead Dog Annual Membership (SCC T-shirt, plus hat or key chain)

T-Shirt Size:_______

 

$100 - Hardman Annual Membership (SCC T-shirt, hat and key chain)

 

T-Shirt Size:_______

 

$500 - Rock God - Lifetime Membership (Embroidered Fleece Jacket)

 

Jacket Size:________

 

$1000 - Lifetime Membership (Embroidered Fleece Jkt, plus t-shirt, hat or key chain)

Jacket Size:________

 

$5000 - Lifetime Membership (Embroidered Fleece Jkt, plus t-shirt, hat and key chain) 

Jacket Size:________

 

___ Thank you, but keep the swag and spend the money on access.

Any questions? info@seclimbers.org
 
Comments:  ___________________________________________________________