Friends
of Massapequa Preserve
Membership
Application
We
are a Not-For-Profit Organization
Print
this page, fill it out, and mail it to:
-
Friends of
Massapequa Preserve
-
90 Pennsylvania
Avenue, 2nd Floor
-
Massapequa,
NY 11758
Annual Dues
___ Individual/Family..............$15
___ Student/Senior..................$10
___ Non-Profit
Organization....$25
___ Business............................$35
___ Additional
Donation..........$_____
Name __________________________________________
Address ________________________________________
_______________________________________________
Phone _________________________________________
Email __________________________________________
I'd like to help
with:
_______________________________________________
_______________________________________________
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