Membership Signup

Membership Details?

  • Apply for membership by scheduling an appointment, filling out and submitting the form below.
  • The Director will contact you to setup a meeting to discuss our programs.
  • After interview the Director will make the decision as to whether our programs are best suited for the individual.
  • All applicants and their parents (when applicable) must sign the  “MAC Conduct Rules” agreement.
  • Upon acceptance there is an enrollment fee of $45 and the first month’s membership fee of $25.
  • Future membership fees can be paid online or in person.
  • Meetings are held at 8359 Beacon Blvd. Executive Suites.

Monthly Membership Fees are $25 per month due by the first of each month.

Fill out and submit the form below or call 239.201.8133 to schedule your appointment.

Your Legal Name (required)

Your Email (required)

Your Address (required)

City (required)

State (required)

ZIP (required)

Phone (required)

Date of Birth (required - mm/dd/year)

Your Current Situation (Please select one)

If you live at home, enter parents full name

Emergency Phone Number

Do you have any allergies to foods or medications? (Please list)

Level of Education Completed

Please list degree or Train Program if applicable

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