APPLICATION FOR TEMPORARY MEMBERSHIP

1

I (we) hereby apply for Temporary Membership in the Eagles Mere Association.

Applicants:

____________________________________________

____________________________________

(print name)

(signature)

____________________________________________

____________________________________

(print name)

(signature)

My (our) home mailing address is ___________________________________________________

________________________________________________Phone:_________________________

2

I (we) hereby certify that I am (we are);  (A) renting a cottage within the Borough of Eagles Mere or

the Greater Eagles Mere Area that is owned by a Shareholder or Associate Member of the EMA,

or that, (B) we are a guest at an Inn, B&B or Lodge that is a member of the EMA.

Rental Residence

(A)

(B)

______________________________________________

_______________________________

(name of cottage and/or Owner)

(Inn, B&B, Lodge)

3

I (we) understand that we must become Temporary Members for the entire period of our stay in

Eagles Mere, that we cannot choose to become Temporary Members for just a portion of our stay.

Rental Period:

From: _________________________________

To: ____________________________________

Payment of Dues:

Enclosed is a check in the amount of $________________ for Temporary Membership in the EMA.

4

I (we) understand that as Temporary Members we agree to abide by the By-Laws and Rules and

    Regulations of the Eagles Mere Association.  (A complete copy is available at the Beach Desk).

Membership approved by:   (To be Completed by EMA)

_____________________________________________________

Date __________________

(Signature of EMA Designee)

5

  Return Application and Check to:

Eagles Mere Association

Phone:

570-525-3515

Box 308

E-Mail:

emalake@epix.net

Eagles Mere PA, 17731

6

Important  --------

In the space provided on the back of the application please list all other adults

who will be staying in the cottage during the rental period.  They (and their families) will be covered

by the Temporary Membership and have access to EMA facilities and property.

Additional Temporary Members

1

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2

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3

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4

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5

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7

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8

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13

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