Friends of Lake Williams, Inc.

Membership Application

Enclosed is my/our check for 2014/2015 membership dues for the period of July 1, 2014 to June 30, 2015.

q       $35.00 Individual Membership

q       $70.00 Family Membership (2 or more people)

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

56 Leonard Bridge Road

Lebanon CT 06249

* Donation are encouraged and welcome because of the increased cost for treatment of the new invasive weed (fanwort) that was discovered in 2012.