Membership Level (Circle One)
Adult (Ages 18 to 63) - $20.00                                   Lifetime - $250.00

Youth Only (Ages 5 to17)  Please note this is a non-voting Membership - $10.00

First Name:                                             Maiden Name:
Last Name :                                            Address:

City:                                                       State:

Zip code:                          Phone: (        )                            Cell: (      )

Birth date: Month             Day                 Year    So we can remember your birthday with a card!

Email:                                                      Clan Connection:

Signature:                                                                           Date:

Do you attend any Events/Festivals/Games?                      If so, where?

Do you have children in your family who might be interested in the Youth Pages? Age (s)                                                     

Tell us about yourself - play drums or bagpipes, Highland dance, want to convene an event, interested in genealogy, clan history, want to serve on a committee or the board, etc.

Any suggestions for us?

Any questions for us? 

Mail to: Banning P. McKeon
11757 W. Ken Caryl Avenue  #134
Littleton, CO  USA

(Please make all checks payable to Clan MacLennan USA)