I wish to enroll as a member for one year. Attached is the membership fee
of $35 and additional $10 for each family members.
Please hand or mail this
form to the Treasurer, Heidi Hoeller.
Email:heidi.m.hoeller@gmail.com
Mail:PO Box 1356, Lakeville, CT 06039
PLEASE PRINT ONLY !
NAME:
ADDRESS:
PHONE:
EMAIL: