Protect the Future of Pleasant Pond

MEMBERSHIP APPLICATION

JANUARY 2004 - DECEMBER 2004

Name (s): ______________________________________________________

______________________________________________________

ADDRESS: Summer Winter (if different)

Street ______________________ ___________________________

Town & State ______________________ ___________________________

Zip ______________________ ___________________________

E-Mail ____________________________________________________

TYPE OF MEMBERSHIP:

Waterfront Property Owner $20 ( )

Non-Waterfront Association Member $10 ( )

Please tell us where you would like to see the efforts of the PPC directed:

Ways I would be willing to help:

Comments I Concerns I Suggestions:

WWW.ppcturner.orq

Please return to Arthur Grant, 556 Fish Street, Leeds, ME 04263