Friends of Pemaquid Point Lighthouse MEMBERSHIP FORM

Thank you for your interest in joining the Friends of Pemaquid Point Lighthouse. Please fill our the application completely and return to us at the address below.

The Friends of Pemaquid Point Lighthouse is a chapter of the American Lighthouse Foundation. Your dues payment to FPPL also entitles you to a membership in ALF, a subscription to Tower Notes and an ALF window decal.

Membership Level:

□	FPPL Sustaining Member	$ 100
□	FPPL Sustaining Member	$ 50
□	FPPL Sustaining Member	$ 25
□	FPPL Sustaining Member	$ 10
□	FPPL Sustaining Member - Other Amount	$ _________

□	FPPL Volunteer Only

Please Print:

Name: _____________________________________

Address: ___________________________________

___________________________________________

City, State, ZIP: _____________________________

Phone: _____________________________________

Email: _____________________________________

** Please fill out areas of Interest at the bottom of this page**

_____ Check/Money Order enclosed payable to: Friends of Pemaquid Point Lighthouse (FPPL)

Circle Areas of Interest Below:

Docent Maintenance/Upkeep Publicity

Fundraising Financial Support Other______________

Availability:

Please Circle your preferred days/ times

Sun Mon Tues Wed Thurs Fri Sat Sun

10-1 11-1 1-5 Other___________

Signature: _____________________________________________

Date:__________________________________

Mail application and payment to:

Friends of Pemaquid Point Lighthouse

P.O. Box 353

Bristol, ME 04539-0353

For more information on our organization, contact:

Marty Welt, FPPL President

Tel: (207) 563-2739

Email – Marty Welt, backlog@tidewater.net