MEMBERSHIP APPLICATION
MEMBERSHIP ANNUAL LIFETIME
______SINGLE ______$25 _______$150
______FAMILY ______$35 _______$200
______BUSINESS ______$50 _______$300
______PATRON _______$500
______BENEFACTOR _______$1000
Names(s) _________________________________________________________
_________________________________________________________________
Address _________________________________________________________
_________________________________________________________________
Town ____________________________________________________________
State _______________________________ Zip __________________________
Telephone # _______________________________________________________
E-Mail ____________________________________________________________
Make checks payable to:
Friends of BLSP
Mail to:
Friends of BLSP
P.O. Box 923
Barnegat Light, NJ 08006
