Print
this page, fill out the form below, and mail with your check
to:
Lakes Environmental Association
230 Main St
Bridgton, ME 04009
I WISH TO JOIN IN THE FOLLOWING CATEGORY:
[ ] $50 Individual [ ] $75 Family [ ] $100 Lake Steward [ ] $250
Sponsor
[ ] $500 Patron [ ] $1,000 Benefactor [ ] Any Other Amount $_________
I wish to make an additional contribution for the Summer Intern
Program. $_________
Check [ ] if you don’t
want your gift of $250 or more acknowledged in our newsletter.
Name (s):_______________________________________________ Year:__________
Winter Address: Summer Address:
________________________________ ___________________________________
________________________________ ___________________________________