Contact Name:

Title:

Company Name:

Address:

City, State, Zip:

Phone:

E-mail Address:

Membership Options:
Associate Membership........................$365
Corporate Membership.......................$695
Charter Membership*.........................$365
*Current Bangor Region Chamber of Commerce Member

Annual Membership:

Total Amount Due:

Enter 'wellness' here:

Wellness Council of Maine
519 Main St. Bangor, ME 04402
Phone: 207.947.0307
Fax: 207.990.1427
E-Mail: wellnessdirector@bangorregion.com