Home

THE LAPIDARY &

MINERAL SOCIETY

OF CENTRAL CONNECTICUT

MEMBERSHIP APPLICATION

For a 1-year membership, please clearly and accurately fill out the form below

and mail the appropriate dues to:

Eva Kupisz, Treasurer LMSCC, 109 Indian Hill Road, Newington, CT 06111

or pay in person at a regular club meeting.

Dues are $15 family/household, $12 individual. 

Checks must be made payable to LMSCC.

For family memberships, please list all names of family members who will participate in club field trips. 

The club needs this information to make sure everyone is covered by our liability insurance,

it is used for club purposes only and is not distributed or sold.

The monthly newsletter, the Chip 'n' Pick, will be sent via email. 

Membership cards can be obtained from the Treasurer at the regular monthly meetings.

Name(s) - Adults

 

Name(s) - Children

 

Address

 

Phone

Email