| Madawaska Historical Society Membership Form/Dues Payment |
| Please print this form and mail it with a check or money order to: Verna Cyr-Fortin, Membership Chairperson 497 Grandview Ave Madawaska, ME 04756 |
| Name: __________________________________________________ Address:_________________________________________________ _________________________________________________ E-Mail___________________________________________________ Annual ($10)____ Lifetime Single ($50)____ Lifetime Couple ($75)____ Please provide the membership chairperson with your new address if it has changed. Thank you for your support. |