Membership Form
Mainewoods Dance Camp, Inc.The Mainewoods
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deepen our friendships. They are greatly appreciated!
YES! I (we) want to help sustain the Mainewoods Dance Camp
community!
Name(s): _____________________________________________________
Address: _____________________________________________________
State/Province: _____________________ Zip: ______________________
Country: __________________________
Phone: (_____ )________________ Fax: (_____ )___________________
e-mail: _____________________________________________________
BASIC MEMBERSHIP (select one):
__$25 for Individual Membership
__ $40 for Family Membership
I'D LIKE TO CONTRIBUTE MORE. Amount $_________
TOTAL AMOUNT ENCLOSED $___________
I wish my contribution to be anonymous. Yes __ No __
All contributions are fully tax deductible to the extent allowed by law. Please make checks out to Mainewoods Dance Camp, Inc. and send to:
Helen Blum, Registrar
Mainewoods Dance Camp, Inc.
926 Bloomfield Ave., Apt. 3F
Glen Ridge, NY 07028
973-787-4614
For any questions regarding Membership, email info@mainewoodsdancecamp.org