please print out this form, fill it out and mail it

S.A.A. Application for New Membership

I am at least 18 years old and have camped at Camp Sequassen

please print
    Name :
     
 :
    Address :  
:
    City, State Zip :  
:
    Telephone: 
:
    email address :  
:
    I first camped at
    Sequassen in :     
:
    Scouting Background :
     
:
    Comments

     
:

Please include a $25.00 check for this year's Annual Dues made out to the
"Sequassen Alumni Association"

Mail to:
Sequassen Alumni Association 
c/o Dave Smith 
395 East Main Street 
Branford, CT 06405-2944 

* note: A Family Membership is available for $50.00 each year for those living at the same address,
but a separate application must be filled out for each member