[OPPORTUNITIES] [MEMBERSHIP BENEFITS]

Membership Application

Please print and mail this form to:
Friends Of Seguin Island
72 Front Street, Suite 3
Bath, Maine 04530
 

NAME (s):  ___________________________  TELEPHONE: (______)_________________

ADDRESS:  _________________________________________________________________

CITY:  ________________________________  STATE: ________________  ZIP: ________

Enclosed is my/our contribution for continuing membership in the Friends of Seguin Island, a non-profit corporation, organized for the purpose of maintaining, restoring and preserving Seguin Island and its structures.

INDIVIDUAL                                                         $25.00                  

FAMILY                                                                 $50.00                  

BEST FRIEND                                                      $100.00                  

LIGHTKEEPER                                                   $250.00                  

LIFE MEMBER                                                  $1000.00                  

Enclosed is my check or I have indicated my credit card payment choice below.

            VISA or MasterCard Credit Card # _____________________________________________

            Expiration Date: ____________

I would like to receive a Friend of Seguin decal.

THANK YOU VERY MUCH FOR YOUR SUPPORT!