Date:_____________                     

 Clan MACNAB Society of North America

Full Name (please print):  ___________________________________________
Address:  _______________________________________________________
Telephone:______________                        Occupation:___________________  
Email Address: ____________________________

 Hobbies, Interests, Special skills and talents you can contribute (examples: write articles 
for the newsletter, host a gathering, run a clan tent at games in your area, make banners & signs): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

 If your name is not one of those eligible for membership, please explain how you are
descended from an ancestor of eligible name: ________________________________________________________________ ________________________________________________________________

 ________Individual membership (only person living in household): $30.00 per year
 ________Household membership: $35.00 per year

 Household Memberships

 Name of Spouse or other adult resident(s): ______________________________ 
 Names of children living at home: _____________________________________

For questions, please call David McNabb at  928-771-1218