Name:

________________________________________________

DOB:

________________________________________________

Name:

________________________________________________

DOB:

________________________________________________

Street Address:

________________________________________________

City/Town:

________________________________________________

State:

___________

Telephone (optional):

________________________________________________

E-mail address:

________________________________________________

By my signature on this application, I signify that I will support the purpose and objectives and will abide by Article II of the By-laws of The Finnish Center at Saima Park, Inc.

Signature:

________________________________________________

________________________________________________

Make the check payable to "The Finnish Center at Saima Park, Inc." and mail the application plus your check for the appropriate amount to:

The Finnish Center at Saima Park, Inc.

Membership Secretary

F.C.S.P.

P.O. Box 30

Fitchburg, MA 01420-0030