https://docs.google.com/document/d/1-MAwX5JR9Ye_4-vxFfGML4JQcvwP2TCh4CcyFDJ_Fck/edit

Mail or Delivery:
26 Washington Street
 Penacook, NH 03303

FAX: 603.753.0009

The above is a Google Doc.  If you are logged into Gmail, you can make a copy and fill it out in Google Drive.  You can also download it as a Word Document.