Membership Form - The Maine Council of the Atlantic Salmon Federation is nonprofit organization for the protection of native anadromous fish species of Maine rivers.

Membership Application

	Application for Membership Maine Council - ASF c/o Mary Jo Barrett ASF Fort Andross, Box 35 14 Maine Street, Suite 406 Brunswick, ME 04401
Please complete this form and mail to the above address.
Check one below:
___ Donation	___ Membership ($20.00)
___ Dual Membership ($40.00 Maine Council and ASF)

Name:	________________________________________
Mailing Address:	________________________________________
City:	________________________________________
State: _____________	Zip: ________________
Phone:	( ) _____________________________________
Email:	_________________________________________
Type of Credit Card:	____________________________________
Credit Card Number:	___________________________________
Exp. Date:	__________________
Signature:	______________________________________
Amount:	$___________________
(Maine Council is a nonprofit, 501 (c) 3 organization)

Please do not send this information to us through email! Thank you.