BCCI Mission Statement: To provide monetary and volunteer assistance and ideas to the State of New Jersey in accomplishing the mission of preservation and interpretation of Batsto Village, teaching its industrial, social, and political history and providing opportunities and events for the enjoyment of the public.

Name___________________________Spouses Name__________________________

Telephone_______________________Email Address :__________________________

Address:________________________City/State/Zip:____________________________

Education: Secondary 1 2 3 4 5 6 7 8 9 10 11 12 (circle) Higher Education: 1 2 3 4 (circle)

Degrees____________________________________________

Type of Occupation___________________________________

Special Skills________________________________________

Interests and Hobbies:________________________________

Organizations of which you are now a member:____________________________

What type of volunteer work would you like to do? Choose 3 and rank 1,2,3)

* Interpretation_______* Public Information_________* Crafts__________

* Fund Raising_______* Schools Program__________* Publications_____

* Office Assistance____* Special Events __________ * Other___________

How much time can you give? Weekly:____________Monthly:_________________

Available Time Periods________________________________________________

Reasons for interest in membership:______________________________________.

How did you hear about us?____________________________________________

Please provide the names and addresses of three personal references:

Signature:__________________________________Date:_____________________

Mail to: BCCI Membership Chairperson c/o Wharton State Forrest, 4110 Nesco Road, Hammonton, NJ 08037