Friends of Maine State Parks              Yearly Dues: (January 1 – December 31)

C/O Tom Cieslinski, Treasurer                       

44 Burke Street

Farmingdale, Maine 04344                 Phone: 207-582-1654                         

INDIVIDUAL MEMBERSHIP         $10 per year or         $25 for 3 years

FAMILY MEMBERSHIP                  $15 per year or          $40 for 3 years

Additional Donations:      

$___________ Day Use Passes   $___________Other

Name(s):          __________________________________________________________________

Address:            __________________________________________________________________

City/Town:      _________________________State: _______________Zip: ___________

Telephone:       _________________________e-mail _____________________________

Make all checks payable to: Friends of Maine State Parks

(Please print this application and send it to Tom Cieslinski with a check.)