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Print out this page and mail with your check to the address below.



Audubon Membership Application

Please enroll me as a member of the National Audubon Society and the Naugatuck Valley  Chapter.  Please send AUDUBON Magazine, Newsletters and my membership card to the address below.

___ Yes, I'd like to join the National Audubon Society and NVAS.

___ My check for $20 is enclosed. (Special introductory rate, basic dues are $35.)

___ As a senior citizen or a student, I am eligible to join for only $15.

___ I would like to receive a newsletter on-line.

      Name: ________________________________
      Address: ______________________________
      City: _________________________________
      State: _______ Zip: _________-_______
      E-mail: _________________@_____________

Please make check payable to: National Audubon Society.

Send this application and your check to:

Naugatuck Valley Audubon Society
PO Box 371
Derby, CT   06418

Chapter Code:  D56
7XCH

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