Membership Application/Renewal

This is the Kennebec Association TEST membership application/renewal form. Applicants for new memberships should fill out the form completely. For membership renewals, please include at minimum your name and e-mail address, and also any information that may have changed since the last renewal. Once the form is filled out click on the Buy Now button to pay with credit card, when you arrive at the PayPal page click on the Don't have a PayPal Account in the lower right hand corner.

Is this your first time applying for Kennebec Association membership?

First Name:
Last Name:
Email:
Cottage Street Number and Name:
Cottage Phone Number:
City Phone Number:
Cell Phone Number:
Mailing Address Line 1:
Mailing Address Line 2:
Mailing Address Line 3:

Membership Dues