The Boston Harbor Association 374 Congress Street

Membership Application Form

YES! Please accept my application for membership in The Boston Harbor Association,
the leading harbor advocacy organization working for a clean,
alive, and accessible Boston Harbor.

Please print, fill out, and mail a copy of this form
with your payment to the address indicated above.

1. Select Type of Membership:

Regular Member ($35)	Friend ($100)	Benefactor ($500)
Regular Member Plus ($50)	Sponsor ($250)	Contributor

2. If you selected Contributor, please specify amount: _______________

3. If you would like to make a one-time contribution for Capital Improvements, please check the box and specify the amount.

	Yes, I would like to make a one-time contribution for capital improvements
$ ________	Amount

Memberships above the regular level include additional benefits such as complimentary
tickets to events and boat tours and listing in TBHA's annual report.

4. Contact Information:

Name:	_________________________________________
Affiliation:	_________________________________________
Address:	_________________________________________
City:	______________________
State:	___________
Zip:	___________
Telephone:	______________________ (work) ______________________ (home) ______________________ (cell)
Email Address:	______________________