Please sign me up for another years worth of membership in the Maine Region, AACA. Membership in the AACA is required.

Name__________________________________________ Date__________________________________

Street__________________________________________ Phone: ( )__________________________

City___________________________________________ E-Mail________________________________

State___________________________________________ Zip___________________________________

Pine Tree Chapter Dues of $10.00 run from January to December.

Mail to: Maine Region AACA

C/O Peter Hanson

21 Norway Dr

Chelsea, Maine 04330