Get Md Maintaining Active Citizens Application For Membership 2019-2025

This guide provides you with step-by-step instructions on how to fill out the MD Maintaining Active Citizens Application For Membership online. By following these directions, you will ensure that your application is completed accurately and efficiently.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to obtain the application form. This will allow you to open the document in an online editor for completion.
2. Fill in your personal information by providing your first name, middle initial, and last name in the designated fields. Make sure to input your address, including street, city, state, and zip code.
3. Include your contact details, such as your cell phone number, home phone number, and email address, in the relevant sections.
4. Complete the emergency contact information by entering the name of your emergency contact, their relationship to you, and their phone number.
5. In the personal information section, provide your birthdate in the required format (mm/dd/yyyy). Select your gender and race by circling the appropriate option.
6. Respond to the additional information questions regarding cancer survival and military service by selecting yes or no for each question.
7. Review the conditions of membership and other policies outlined in the document. Initial each section to acknowledge your understanding and agreement.
8. Sign and date the application at the designated area confirming that you have read and agree to all the information provided.
9. In the health history section, input any medications you are currently taking, along with a summary of your medical background including past surgeries and injuries.
10. After completing your information, you can save changes, download the application, print it for your records, or share it as needed.

Start filling out your application online today to ensure your membership at the Richard Henson Health and Wellness Facility.