Application for Membership Clan MacKenzie Society
in the Americas, Inc.NAME____________________________________________________________________
ADDRESS___________________________________CITY_________________________
STATE_______________ZIP__________________PHONE _________________________Name as you wish it to appear on your membership certificate.
__________________________________________________________________________If your name is not MacKenzie or one of its septs, could you tell us how you are related
or interested in the Clan.
__________________________________________________________________________
__________________________________________________________________________Immediate family information (for genealogy purposes)
SPOUSE: __________________________________________________________
Minor Children:
NAME_______________________________________________AGE __________
NAME_______________________________________________AGE __________
NAME_______________________________________________AGE __________
Signature____________________________________________Date __________Recommended by: ____________________________________________________
Downloaded from Clan MacKenzie-L - Official Listserv Site of the Clan MacKenzie Society (US & Canada)
Annual Dues are $15.00 / Checks should be made payable to Clan Mackenzie Society in the Americas, Inc.
Please mail this application along with your annual dues to:
- Annette McKenzie, Secretary - 101 Johnston Street SE - Decatur, AL, 35601
or give to your clan representative at any of the Highland Games