2021 Annual Dues

Member's name (s): _________________________________________________________________________________
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):   _______________________________________________________ 
Mailing Address:  ________________________________________        Local Lake   ___________________________________________
                                 ________________________________________         Address:      ___________________________________________                                   ________________________________________                               ___________________________________________
                                 ________________________________________                               ___________________________________________
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
Loon Conservation
Lake Water Sampling