membership form


(NOTE: We do not sell or publish your member information for any reason. We will not call your mobile phone or send a text unless there is an island specific need. For more information please call 978-463-0670)

Membership Application

First Name


Last Name


Email Address


Cell Phone


Other Phone


Mailing Address

Street


City


State


Zip Code


Plum Island Address

Same as mailing address

Street


City


State


Zip Code


Membership Type

Volunteer
Would you like to be contacted for PITA volunteer projects?