Internet app.

 

N.H.P.A./M.H.P.A  Membership Form 2013

 

Name   _________________________________________________

 

Address _________________________________________________

 

City______________________      Zip  _____________________

 

Phone______________________      Date of Birth  ______________

 

e-mail address  _____________________________________________

 

New   ____        Renewal   ____   NHPA card #   _________________     

 

How many years?  _____________

 

Circle category:

 

Men 40 feet       Elders 30 feet       Women 30 feet       Juniors 30 feet

 

Adults:  $17 for NHPA and $8 for MHPA, total $25

Juniors: $5 for NHPA and $5 for MHPA, total $10

 

Cathy Neumann

72 Six Rod Road

Fairfield, ME  04937

Phone:207-453-7443  e-mail:  neumann8691@roadrunner.com

 

 

N.H.P.A./M.H.P.A  Membership Form 2013

 

Name   _________________________________________________

 

Address _________________________________________________

 

City______________________      Zip  _____________________

 

Phone______________________      Date of Birth  ______________

 

e-mail address  _____________________________________________

 

New   ____        Renewal   ____   NHPA card #   _________________     

 

How many years?  _____________

 

Circle category:

 

Men 40 feet      Elders 30 feet       Women 30 feet       Juniors 30 feet

 

Adults:  $17 for NHPA and $8 for MHPA, total $25

Juniors: $5 for NHPA and $5 for MHPA, total $10

 

Cathy Neumann

 72 Six Rod Road

Fairfield, ME  04937

Phone:207-453-7443        e-mail: neumann8691@roadrunner.com