Millers River Environmental Center
Athol Bird and Nature Club
Membership form

The Millers River Environmental Center is managed by the Athol Bird and Nature Club.

This is a:
New membership
Renewal membership
Former member returning

Type of Membership?
Student ---- $5.00/yr
Individual $15.00/yr
Family ---- $25.00/yr
 
     Contributer $50.00/yr
     Patron $100.00/yr
     Benefactor $250.00/yr
        To order an ABNC decal.
       for outside of window add $1
       for inside of window add $1

  *   Starred fields are required
    Member name * 
    Street or P.O. Bx * 
    Town *  State *  Zip * 
    Phone Number(s)    
    Email address * 
     This is a gift membership from
   
   Please send a gift card yes no
I would like to make an additional donation
to the Millers River Environmental Center (MREC):
Amount $
Anything you would like to add...
 
Although we will begin to process your membership, it will not become active until the fees checked above have been received.

After you submit this form you will be given the opportunity to "Pay Now" through PayPal

or you can
Make check payable to: Athol Bird and Nature Club

Send to:
Athol Bird and Nature Club
c/o Millers River Environmental Center
100 Main Street,
Athol, MA 01331-2222

Amounts over $15.00 are tax-deductible.

Pleae call us with any questions
978-248-9491

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