Name: ____________________________ Check Appropriate Box $10 Individual Membership $20 Family Membership Check One Resident Membership (open to all residents of the Towns of Stockton, Pomfret and Charlotte within three miles of the Cassadaga Lakes and its tributaries.) Non-resident Membership Your help would be appreciated I would be willing to help out or assist in CLA activities. Please contact me. Phone: ____________________________ Email: ____________________________ Address: ____________________________ ____________________________ ____________________________ Thank You!

Mail Your Membership Form along with Membership Dues To:

Cassadaga Lakes Association                 PO Box 294                 Cassadaga, NY 14718            (make checks payable to: The Cassadaga Lakes Association)