The Thousand Islands Association

MEMBERSHIP APPLICATION

PLEASE COMPLETE AND PRINT OUT THE FORM BELOW AND FAX TO 315-233-0347
OR SEND TO THE CORRESPONDING ADDRESS BELOW AND SEND YOUR
CHEQUE FOR:  $30$75$500

NAMES:_________________________________________________________

WINTER ADDRESS:_______________________________________________

STREET:_________________________________________________________

CITY:____________________________________________________________

STATE/PROV:____________________________________________________

ZIP/POSTAL CODE:_______________________________________________

TELEPHONE:_____________________________________________________

SUMMER ADDRESS:______________________________________________

STREET/ISLAND:_________________________________________________

CITY:____________________________________________________________

STATE/PROV:____________________________________________________

TELEPHONE:____________________________________________________

POSTAL ADDRESS:

CANADA	U.S.A.
P.O. BOX 274 Gananoque, Ontario Canada K7G 2T8	P.O. BOX 718 Wellesley Island, NY 13640 U.S.A.