Quinnipiac River Watershed Association (QRWA)

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To become a member or to renew your membership fill out the form below or you may download the membership level form via Adobe Acrobat; click here if you don't have a copy of the Adobe Acrobat Reader, download one free from Adobe at www.adobe.com We are no longer able to fulfill the pictured items with new membership, however, all membership renewals and new membership will receive a QRWA membership card.

If you are mailing a form, or application with a payment please send it to:

The Quinnipiac River Watershed Association
PO Box 2825, Meriden, CT 06450
Attn: membership

Please tell us about yourself: ( denotes required fields)*

Organization

First Name *

Last Name *

Address

Suite

City

State		Zip

Phone *

Fax

Website

Email *

Please select a membership or donation level from the list below:
(Select all that apply. You will be asked to calculate your total donation for PayPal on the next screen.)

	Student/Senior Membership: $15 includes Membership Card
	Individual Membership: $20 QRWA embossed silicone bracelet
	Family Membership: $30 includes all of the above plus a tote
	Wood Duck/Bronze Member: $75 includes all of the above plus a t-shirt
	King Fisher/Silver Member: $175 includes all of the above plus a picnic blanket in a bag
	Turtle/Gold Member: $350 includes all of the above plus folding chair
	Osprey/Platinum Member: $700 includes all of the above plus free canoe/kayak instruction for family of 4
	Bald Eagle/Life Member: $1000+ includes all gifts plus use of our facility, including boats for one day, up to 6 hours in accordance with "reservation guidelines and instructions" as outlined in the QRWA rental agreement
	No need to include any items with my membership

Other Donation Level

	QRWA building fund
	Bee and Butterfly Habitat
	Environmental Education
	Fish Stocking Fund
	Source to Sound Fund

Additional Comments:

(please use this area to identify any other level of contribution and/or membership you plan to make online via PayPal.)

Please do not send any merchandise we are happy to provide a monetary donation.

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Web Solutions Connecticut CT Web Design & Development Company

Watershed Base Plan Final Report

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Please select a membership or donation level from the list below: (Select all that apply. You will be asked to calculate your total donation for PayPal on the next screen.)

Other Donation Level

Additional Comments:

Please tell us about yourself: ( denotes required fields)*

Please select a membership or donation level from the list below:
(Select all that apply. You will be asked to calculate your total donation for PayPal on the next screen.)