___ I want to renew my membership; ____ New Membership
Name:_____________________________________________________
Address:___________________________________________________
City:_____________________________ State:______ Zip:___________
County:________________________ Phone:_____________________
E-Mail Address:_____________________________________________
______ $15 Individual JR______ SR____________ $20 Family - please list members below:(add another sheet, if necessary)
_______________________________________ JR____ SR____
_______________________________________ JR____ SR____
_______________________________________ JR____ SR____
_______________________________________ JR____ SR_____
At what level do you ride?___________________________________
What benefits or services would you like to get from MeCTA this year?
_________________________________________________________
_________________________________________________________
_________________________________________________________
I would like to volunteer to help MeCTA. Contact me for volunteering at:
____Clinics ____Events ____Annual dinner ____other (please specify) __________________________________________________________
Make checks payable to MeCTA
Return to: Cheryl Norton cheryl@IslandMeadowsFarm.com
378 Gay Island, Cushing, ME 04563 207-592-0283
