Blackstone Canal Conservancy, Incorporated

Membership in the Blackstone Canal Conservancy is open to all who are interested in the canal and its preservation.

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MEMBERSHIP APPLICATION

Mail to: Blackstone Canal Conservancy
            16 Ballou Road
             Hopedale, MA 01747-1833

Names:                                                                                            .

Address:                                                                                             .

Town/State:                                                                                        .

Zip +4:                                                                  .

Phone number:   (              )                                     .

 

Annual Dues: Student         $ 7.00

                   Individual          10.00

                      Family           15.00

              Organization          25.00

Additional Donation: .General:                                   .

                    Canal Boat fund:                                  .

                                       Total:                               .

Checks payable to: Blackstone Canal Conservancy

Revised: 5/28/12