Friends of Lake Williams, Inc.

Membership Application

Enclosed is my/our check for 2008/2009 membership dues for the period of July 1, 2008 to June 30, 2009.

q       $30.00 Individual Membership

q       $60.00 Family Membership (2 or more people)

q       $25.00 Business Card Ad in Newsletter

q       $_____ Tax deductible donation

Name: ______________________________________________

Street Address:_______________________________________

City/State/Zip: ________________________________________

Telephone Number: ___________________________________

E-Mail: ______________________________________________

Please make checks payable to Friends of Lake Williams and send your dues and tax-deductible donations to:

Friends of Lake Williams

PO BOX 216

Windsor CT 06095