GREAT MOOSE LAKE ASSOCIATION MEMBERSHIP FORM

 (Membership year runs from July 1 to June 30)

 

Name:_____________________________________________________________

 

Summer Mailing Address:____________________________________________

 

Zip_________

 

Location on Lake:___________________________________

 

Winter Mailing Address:____________________________________________

 

Zip_______________

 

Summer Phone:_______________ Winter Phone:_______________________

e-mail address:__________________________

 

Year- Round Resident: YES £  NO  £

Membership ($20) £

Donation $____________£

 

                                 

Are you willing to serve on the Board?

YES  £NO £

Are you willing to become a Boat Launch greeter?

   YES £       NO£

 

 

Make checks payable to: GMLA

 

Mail to :  Great Moose Lake Association

P. O. Box 555

Hartland, ME 04943

Attn.: Arthur D. Childs, Treas.