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MEMBERSHIP APPLICATION

Thank you for your interest in becoming a member.  Please provide the following information:
NAME  
STREET (line1)  
STREET (line 2)  
CITY  
STATE  
ZIP  
PHONE  
E-MAIL  
MEMBERSHIP TYPE FAMILY ($15/yr)   BUSINESS/ORG ($50/yr)  

  In the space below, please let us know your interest in the rivers or any volunteer abilities that you may possess and are willing to share.  (Use the reverse side if necessary.)
 

To register your membership, print this page and legibly complete the required information.

Send the completed form with cash, check, or money order (payable to MPRA) to:

MPRA - Membership Application

P.O. Box 157

Walkerton, VA  23177


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 Copyright 2007, The Mattaponi and Pamunkey Rivers Association, Inc.
All rights reserved.