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UMASS CRANBERRY STATION NEWSLETTER APPLICATION Fill out this form and return it to the Cranberry Station: Fax: 508.295.6387 Mail: NAME:_________________________________________________ COMPANY:______________________________________________ ADDRESS:______________________________________________ TOWN/STATE:___________________________________________ ZIP:__________________________________________________ PHONE:________________________________________________ Selling Agent?________________________________________ Change of address (Y or N) Delivery Method (Circle one): E-MAIL or REGULAR MAIL **NOTE** If you are a NON-MASSACHUSETTS recipient and select Regular Mail please include a check for $15.00 Are you a(n) (Circle one):
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