New England Carnival Glass Association Membership Application

Dues: $ 18.00 per year per household within the U.S.
$ 21.00 per year per household outside the U.S.
(Membership renewal is due on your anniversary date)

Name______________________________________
Address____________________________________
City____________________State________ Zip Code__________
Telephone # _____-_____________ Email address: ______________________

Send application form and dues (U.S. funds) to:
Joanne Andrews Membership includes, bi-monthly meetings, bulletins
P.O. Box 100 and all functions and outings.
Limerick, ME 04048-0100
Make checks payable to N.E.C.G.A.
New _____ Renewal _____