Click here to download a Microsoft Word (28KB) copy of the Membership form that you can print and mail in:
LAKE NIPMUC ASSOCIATION MEMBERSHIP FORM

MEMBERSHIP FORM

The Lake Nipmuc Association is a volunteer organization. We rely on grants, donations and membership dues to support our programs.  (After filing with the state we can add Donations to the Lake Nipmuc Association are tax deductible).

Student                $ 10.00
Individual             $ 20.00
Family                  $ 25.00
Business                $ 60.00
Patron                  $100.00
Benefactor           $200.00
Steward               $500.00

Member Information

Name __________________________________

Address________________________________

City  ___________________________________

State_____________   Zip Code_____________

Phone__________________________________

Email __________________________________

Mail To:

Lake Nipmuc Association

PO Box 159

Mendon, MA  01756

This page was last updated on 01/10/10.