Membership Dues

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First Name

Last Name

First Name 2

Last Name 2

Address Line 1

City

State

Zip

Email

Email 2

Home Phone Format: 123-456-7890

Cell Phone Format: 123-456-7890

Membership Levels

Trees (maintenance & reforesting)

Fundraising/WNA Improvements

Newsletter/emails

Welcome Committee

Gardens of Waterbury (maintenance)

Photography

Luminaries

Media (web site, social media)

Social Events

Special Projects/Other

Board of Directors

Credit Card

Check / Cash