membership gift

1. Please make your check payable to “CLA” and mail it to
the address below:

Cobbosseecontee Lake Association
PO Box 17
Manchester, ME 04351

2. Please provide complete information about yourself and your gift recipient in the form so we can welcome your gift recipient to CLA and keep them informed throughout the year.

A gift acknowledgment and tax receipt will be mailed to the address on the check.

If you prefer that information be sent to a different address, please provide that address with your payment.

CLA is a 501c3 charitable organization filed as:
CYC Lake Association Federal Tax ID:
84-2081478

Name

First Name

Last Name

Recipient's Email

Phone

(###)

###

####

Primary Address (Street, City, State, Zip)

Lake Address (Street, City, State, Zip)

Would you like this gift to be anonymous?

Yes

No

Recipient's Name

First Name

Last Name

Recipient's Address (Street, City, State, Zip)

Email

Special Instructions/Additional Information

Amount

$

Message to include in gift membership email