UMASS CRANBERRY STATION
       NEWSLETTER APPLICATION

Fill out this form and return it to the Cranberry Station:

Fax:
508.295.6387
Attention: Deb Cannon

Address: UMass Cranberry Station
c/o Deb Cannon
P.O. Box 569
E. Wareham, MA 02538
  NAME: __________________________________________________
  COMPANY: __________________________________________________
  ADDRESS: __________________________________________________
  TOWN/STATE: __________________________________________________
  ZIP: __________________________________________________
  PHONE: __________________________________________________
  Selling Agent? __________________________________________________

Change of address (  Y  or  N  )

Do you wish E-MAIL  or  REGULAR MAIL  delivery? (Circle one)

NOTE! If you select Regular Mail please include a check for $15.00

Please write e-mail address if you have selected e-mail delivery
__________________________________________________

Are you a(n) (Circle one):

bullet-black    Owner (number of acres) _____

bullet-black    Employee of cranberry operation

bullet-black    Researcher

bullet-black    Consultant

bullet-black    Town, State, or Federal employee

bullet-black    Interested parties not directly involved with cranberry industry

bullet-black    Other (please explain)