2012 Merrimack Valley Chapter Membership Renewal/ Information Change
Your MSOG, Inc. membership year ends December 31, 2011. Please take the time to renew now. We look forward to seeing you in the coming year. We now accept payment through your PayPal account or by Credit Card.
Step 1: Fill in the form completely. Print a copy for your records.
Step 2: Click Submit button below.
AFTER you press the Submit button, you will be able to pay for your membership online using Paypal or a credit card.
If you prefer, AFTER you press the Submit button, mail your membership dues check made payable to MSOG, Inc., along with a print copy of this form to the Merrimack Valley Chapter Treasurer, Diane Laferriere, 42 Sherburne Ave., Tyngsboro MA 01879.
Please print a copy of this form BEFORE you press the SUBMIT button. Please contact the State Membership Director if you have any questions.
When you press the Submit button, your renewal form will be sent to the Merrimack Valley Chapter Treasurer and you will be moved along to the Payment Page.
| Date: | |
| Membership Number: | |
| Your Name: | |
| Your Address: | |
| City: | |
| State: | |
| Zip+4: | |
| Telephone: | |
| E-mail Address: |
Membership Dues: Indicate your choice of membership for year 2012 (pick ONE)
Method to receive Past Times: (pick ONE)
Method to receive MASSOG Journal: (pick ONE)
(no fee for hard copy)
Payment Method (PayPal or Check)
PLEASE PRINT YOUR COMPLETED COPY AND THEN PRESS THE SUBMIT BUTTON.