2021 Annual Dues

Member's name (s): _________________________________________________________________________________

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Membership: $50

Donation: $____________________

Total: $______________________

Please make checks payable to"CLCA"

Print off and and mail to:

CLCA, PO Box 803, Center Conway, NH 03813

E-mail address:                              _______________________________________________________ 

2nd email address (optional):   _______________________________________________________ 

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Mailing Address:  ________________________________________        Local Lake   ___________________________________________

                                 ________________________________________         Address:      ___________________________________________                                   ________________________________________                               ___________________________________________

                                 ________________________________________                               ___________________________________________

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Phone Number:   ______________________________________

(Optional)

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We are looking for volunteers - please let us know if you would like to help:

Yes, I'd like to help

Invasive Species Patrol

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Loon Conservation

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Lake Water Sampling

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