Click here for our new Secure
Online Membership Form, or if you prefer to send in the form
and contribution via the US Postal Service, please fill out and
print the form below.
Please fill out the form below and
include with your payment.
If paying by check, please make it payable to: Friends of the Blaine
House,
Return to: PO Box 68, Augusta, ME 04332
| ___ |
Individual |
$25 |
 |
___ |
Patron |
$500 |
| ___ |
Family |
$50 |
|
___ |
Business |
$1000 |
| ___ |
Supporter |
$100 |
|
___ |
Special Friend |
$1000 |
| ___ |
Benefactor |
$250 |
|
___ |
Other gift |
______ |
Please direct my donation for use
on the project(s) I select:
_____ Restoration
_____ New England Garden
_____ Greenhouse
_____ Game Room |
