Membership Levels

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 to review membership incentive levels. If you don't have a copy of the Adobe Acrobat Reader, download one free from Adobe at www.adobe.com. 

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.

---

Enter the code shown above

More Info

Why Do I Need to Enter This Code? By entering the code you see in the box, you help us prevent automated registrations. This reduces system loads and ensures better performance of our services. If no image appears, please make sure your browser is set to display images and try again. If you are not sure what the code is, make your best guess. If you guess incorrectly, you will have an opportunity to enter a different code on the next screen. Visually impaired or blind users: please contact us for assistance.

---

                   
    Membership items subject to change based on availability.

  |    |   Share