Apply by Mail

Nickerson Association Membership Form

Fill out the form below and click Submit to create a printable PDF

Print out your completed application and mail it along with a check to:

Membership Chairperson
c/o Nickerson Family Association, Inc. P.O. Box 296
North Chatham, MA, 02650-0296
U.S.A.

Name
MM slash DD slash YYYY

Children Under 16

MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY

Your Info

Address

Membership Dues

Enclosed is a check or money order for my membership dues (please check one): USD funds only
Annual Single Membership
Annual Family Membership
(Husband and Wife) (Add $10.00 per child 18 or under)
x $10
Annual Sustaining Membership
Lifetime Membership
This field is for validation purposes and should be left unchanged.

Print out your completed application and mail it along with a check to:

Membership Chairperson
c/o Nickerson Family Association, Inc. P.O. Box 296
North Chatham, MA, 02650-0296
U.S.A.