Membership
_____ Renewal _____ New Member
_____ Single ($15) _____ *Family ($20) *Family membership includes two adults and all children under the age of 18
Name(s) of Adult(s): ________________________________ ____________________________
Newsletter Preference (Check one)
_____via email or _____ via USPS
Number of Children under 18 _____
Mailing Address: ________________________________
________________________________________________
Telephone Number: ________________________________
Email Address: ________________________________
$_________Dues $_________Newsletter via USPS Donation $_________Total Attached
Make checks payable to OCM&G Assoc.
Please print and bring the completed application and payment to a club meeting,
or mail to: Dennis Gross
178 N. Main Street
Bryant Pond, Me 04219
_____ Single ($15) _____ *Family ($20) *Family membership includes two adults and all children under the age of 18
Name(s) of Adult(s): ________________________________ ____________________________
Newsletter Preference (Check one)
_____via email or _____ via USPS
Number of Children under 18 _____
Mailing Address: ________________________________
________________________________________________
Telephone Number: ________________________________
Email Address: ________________________________
$_________Dues $_________Newsletter via USPS Donation $_________Total Attached
Make checks payable to OCM&G Assoc.
Please print and bring the completed application and payment to a club meeting,
or mail to: Dennis Gross
178 N. Main Street
Bryant Pond, Me 04219