** MAXSON FAMILY ASSOCIATION **

MEMBERSHIP APPLICATION

Membership Dues of $15.00 per family cover a period of 1 year, from Jan. 1 through Dec. 31.

Please mail this form and your check made out to Maxson Family Association, to:

Maxson Family Association

c/o Paula M. Pescatello, Treasurer

PO Box 323

West Paris, ME 04289

Your quarterly newsletter will be mailed to you via the USPS.

We try hard to keep our files up to date and therefore ask that you complete the following and return with your check. If you have been a member for a while, or just joined recently, some of your information may have changed since and we just want to be sure we have the most up-to-date information for you and your family. Thank you for taking a few minutes to complete the form below!

Name:__________________________________________________________________________

Street/PO Box:___________________________________________________________________

City/State/Zip Code:_______________________________________________________________

Family members included at this address:______________________________________________

_______________________________________________________________________________

Phone Number(s):________________________________________________________________

Email Address:___________________________________________________________________

OPTIONAL: I would like to make a donation of ___________ to the MFA and have included that amount together with my $15.00 yearly dues.

I am a NEW Member: Y__ N__ (If new member, please include your family tree with this form.)

Please complete the entire form and return along with your check made out to Maxson Family Association to the above address.

Thank You!!