GSWA Membership Application ---- 2003
   

Name: ___________________________________________________________________

Address:  ________________________________________________________________

Town/State/Zip:  _________________________________________________________

Phone number (optional): ___________________________________________________

Email Address:  ____________________________________________________________
(if you have one and would like us to use it)

Please check the type of membership:

$ 1,000 or greater ______ (Steward)  $250 ______ (Benefactor)  $100 ______ (Patron)

$50 ______ (Supporting)  $35 ______ (Member)  $10 _______ (Senior Citizen)

Please make your check payable to:

Great Swamp Watershed Association

Mail to:

P.O. Box 300
New Vernon, NJ 07976

Does your workplace offer a matching gift program?  If yes, please send the form to us and we will complete and return it -- thank you!

Donation are tax deductible as allowed by law and are used to work for the preservation of wetlands and open space in the Great Swamp watershed.