Enclosed is my check in the amount of $________ to cover the cost of: 

(circle your choice)

             Single membership   $22.00 

             Family membership  $27.00 

             12 month subscription to FFI magazine (4 issues) $15.00 

FFI needs the following information for every member in the family membership. If you area single membership, just fill out Member #1 information: 

Name
Member #1_________________________________Phone_________________ 
Member #2_________________________________Phone_________________ 
Member #3_________________________________Phone_________________ 
Member #4_________________________________Phone_________________ 
Address ________________________________________________________________ 
City, State & Zip _________________________________________________________ 
Email 
Member #1________________________________________________________ 
Member #2________________________________________________________ 
Member #3________________________________________________________ 
Member #4________________________________________________________ 

Please return completed form with payment no later than Jan. 31, 2003 to: 
Grace Limoncelli, Treasurer 
18 Indian Drive 
Clinton, CT06413