Healthy Environment, Strong Communities, Accountable Government

Friends of Massapequa Preserve

Membership Application

We are a Not-For-Profit Organization

Print this page, fill it out, and mail it to:

Friends of Massapequa Preserve
90 Pennsylvania Avenue, 2nd Floor
Massapequa, NY 11758

Annual Dues

___ Individual/Family..............$15

___ Student/Senior..................$10

___ Non-Profit Organization....$25

___ Business............................$35

___ Additional Donation..........$_____


Name __________________________________________

Address ________________________________________

_______________________________________________

Phone _________________________________________

Email __________________________________________


I'd like to help with:

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Neighborhood Network
7180 Republic Airport, East Farmingdale, NY 11735 Tel: (631) 963-5454
Advocates for Long Island's Environment