Become A Member

WE NEED YOUR HELP!

 

In order to continue our work in the Damariscotta Lake Watershed, we need your

support! If you are not already a member, please take a moment to print out this form

and send it to us at:

 

Damariscotta Lake Watershed Association

PO Box 3

Jefferson, ME 04348

Phone 207/549-3836 Fax 207/549-3852

Email dlwa@roadrunner.com

 

I would like to become a member of the DLWA!!!

___ Regular Member……………………$15

___ Supporting Member…….…………..$25

___ Patron……………………………….$50

___ Sponsor……………………………..$100

___ Sustaining Member………………….$500

___ Other

 

Please make checks payable to DLWA

DLWA is a 501 (c) 3 not-for profit organization in accordance with IRS code

 

__________________________          Watershed Address (if different)

Name

__________________________          _______________________

Street Address Address

__________________________          _______________________

City Town

__________________________          _______________________

State/Zip State/ZIP

__________________________          _______________________

Mailing address (if different) Telephone

_______________________________

City                                                                                   Do you want mail sent to your watershed address?

_______________________________          ____Yes____No

State/ZIP                                                                       If Yes, dates: From ___________ to __________

__________________________

Telephone

__________________________

Email