2021 GPLA MEMBERSHIP FORM
Anyone may become a member of the Goose Pond Lake Association
Annual membership is $15 per year for each adult. Memberships run from the first week in January to December (our fiscal year). Dues and contributions (always accepted) are used to finance Goose Pond water quality monitoring, Lake Hosting, the Annual Meeting & Picnic, and other Association activities that directly benefit the pond.
Checks for membership should be made out to the GPLA, and mailed to: Goose Pond Lake Association
c/o Rick Hutchins, Treasurer
PO Box 647
Enfield NH 03748
Name(s) to be acknowledged: _______________________________________________________________________________________
Goose Pond address: _____________________________________________________________________________________________
Permanent address: ______________________________________________________________________________________________
Email address 1: _________________________________________ Email address 2: _________________________________________
Goose Pond telephone: _____/_____/______ Other telephone: _____/_____/______
Total amount on check: _______ Total Dues: _______ Additional gift/donation: $________
Please indicate all members being paid for, and amount of gift/donation.
Print this page and send to the address above with your check. We cannot accept credit cards or PayPal at this time.
Loons = $200+
Blue Herons = $100 - $199
Ospreys = $50 - $99
Eagles = $0 - $49