Friends of Baxter State Park
PO Box 1442, Bangor, ME 04402-1442
FRIENDS OF BAXTER STATE PARK
GIFT MEMBERSHIP FORM
Someday we hope to offer on-line gift memberships and electronic payment.  Until then, please print out and mail this form with your payment.


Please send a membership in Friends of Baxter State Park to:

Name__________________________________________________

Address________________________________________________

City_______________________  State___________  Zip________

Phone_________________________________________________

e-mail_________________________________________________


        
Please check membership level:

        _____  $1,000 Gov. Baxter Society

        _____     $500 Katahdin Club
        
        _____     $250 Knife Edger

        _____     $100 Hamlin Peaker

        ______       $50 Sponsor

        ______       $30 Family

        ______       $25 Individual


This gift is being given by:


Name__________________________________________________

Address________________________________________________

City_______________________  State___________  Zip________

Phone_________________________________________________

e-mail_________________________________________________


Make check payable to: Friends of Baxter State Park

Send to:                Friends of Baxter State Park
                        P.O. Box 609
                          Union, ME 04862


Membership contributions are tax deductible to the extent provided by law.