March 20, 2019
MEMBERSHIP APPLICATION FOR
SIPSEY WILDERNESS HIKING CLUB 
 
 
 
 
 
NAME:.............................................................................
ADDRESS:....................................................................... CITY:.....................STATE:........ZIP CODE:................... PHONE:.............................EMAIL:.................................
DATE OF BIRTH:............................................................
MEMBERSHIP TYPE: SINGLE..........FAMILY.............
FAMILY MEMBER NAMES:......................................... ............................................................................................ ............................................................................................ ............................................................................................ ............................................................................................
FOR CLUB USE ONLY MEMBER STATUS MEMBERSHIP DATE...........................
COMMITTEE.........................................
DUES PAID.............DATE.....................
 
Please send check or money order only. $15.00 single, $25.00 family to: Sipsey Wilderness Hiking Club P O Box 1207, Double Springs, AL 35553 Attn: Membership