| Please print this page from your browser and mail with your membership fee. Please mail a check addressed to BPA Treasurer, c/o P.O. Box 850, Holden,
Maine, 04429.
Make checks payable to Branch Pond Association. The BPA is a non-profit
organization.
NAME ___________________________________________________________
LAKE ADDRESS ___________________________________________________
MAILING ADDRESS _________________________________________________
E-MAIL ADDRESS: Summer _________________________
Winter __________________________
ANNUAL DUES: $20.00 __________
ADDITIONAL/SPECIAL DONATION (see below) $ __________
You may specify special uses for ADDITIONAL DONATIONS (please check below):
1. Invasive Species Committee: __________
2. Recreation and Social Activities: __________
3. Boat Inspections at Public Access Points:
__________
4. LakeSmart Committee: __________
5. Historical Committee: __________
6. BPA Development: Newsletters/Surveys: __________
COLA/Conference Attendance: __________
7. BPA Legal Fund: __________
8. BPA General Fund: __________
Thank you for your additional donation.
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