THE LAPIDARY & MINERAL SOCIETY OF CENTRAL CONNECTICUT
MEMBERSHIP APPLICATION
For a 1-year membership, print and fill out the form below and mail dues to:
Eva Kupisz, Treasurer LMSCC, 109 Indian Hill Road, Newington, Connecticut 06111
Dues are $15 for family/household and $12 for an individual.
Checks should be made payable to LMSCC.
Please list all names of family/household memberships who will participate in club activities so we can send the appropriate membership cards and get an accurate membership count, which is required for our insurance coverage:
Name(s)
Name(s)
Address
Phone