MLPA Membership Form

NOTE: If you are "renewing" your membership and your information has not changed from last year you only have to answer FIVE basic questions which are indicated by the "asterisks". If this is a "new" membership, please provide as much information as possible.

The Mirror Lake Protective Association is a 501(c)(3) non-profit organization. All contributions are tax deductible to the extend allowed by law. Please consider doubling your impact by using your company's matching gift program. Mirror Lake Protective Association's Federal ID number is: 02-0450541

MLPA mailing address is: PO Box 311, Mirror Lake NH 03853
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    Please print a copy of this form for your tax records.

    Members donations to the Mirror Lake Protective Association are a contribution for which the donor receives little or no privileges or benefit and are deductible to the extent allowed by law. Please consult your tax advisor. Mirror Lake Protective Association's Federal ID number is: 02-0450541