Page 15 - July 2017 Augusta Elks Newsletter

B.P.O.E., Augusta Lodge #964 P.O. Box 2206
Augusta, Maine 04338-2206 207-623-9623
Name: _____________________________________________ Address: ___________________________________________ City _______________________ State______ Zip: ________ E-Mail: ____________________________________________ Phone: (Home) _______________ (Cell) ______________
2017-2018 Elks Membership
Member #: ____________
Newsletter Preference: Mailed Emailed Both
Are you a Snowbird:  Yes  No
Are You A Veteran?  Yes  No
Please Check One:
 Regular Member Dues $69.00  Life Member Dues $29.00
Additional Tax.Deductible Donation:
 Elks National Foundation (ENF) Amt $ _____________  Youth Activities Amt $_____________
 Lodge Scholarship Program Amt: $ _______________  Veterans Programs Amt $_____________  Maine Children’s Cancer Program (MCCP) Amt $_____________
Special Notes: ____________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________
ATTENTION SNOWBIRDS
Please provide your summer and winter addresses, and if known, the months you will be at each.
Amount Enclosed:
Dues:
Donation(s):
TOTAL:
SUMMER: (same as above)
Address: __________________________________________ Address 2: _________________________________________ City: _____________________ State: _______ Zip: _________ Telephone (if different) ________________________________ Months: ___________________________________________
WINTER: (same as above)
Address: ___________________________________________ Address 2:__________________________________________ City:_____________________ State: ______ Zip: _________ Telephone (if different) _________________________________ Months ____________________________________________
**** If you are experience a nancial hardship contact the Lodge and leave a message for the secretary. It is your responsibility to notify the Lodge Secretary of any changes in your mailing address. elk964secretary1@myfairpoint.net or Call 623-9623
If your Challenge newsletter is returned, it will be stopped until we hear from you.
To avoid this, please consider signing up to receive your newsletter by e-mail if possible.
is will save the Lodge printing and postage costs and allow you to receive your newsletter early.
Challenge • B.P.O.E., Augusta Lodge #964 • Civic Center Drive, Augusta Maine 04330 • 207-623-9623 • augustaelks.org
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