Membership Form 7XCH Y27 |
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(Print out, fill in, and mail with your check to address below) |
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Name: _______________________________________________________ |
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Address: _____________________________________________________ |
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City, State, Zip: _______________________________________________ |
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Phone: _______________________________________________________ |
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E-mail:_______________________________________________________ |
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Add you to our e-mail list? |
___ Yes |
_____ No |
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Volunteer Interests (check interests) |
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Environmental Education |
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________ |
Fund Raising |
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________ |
Membership Recruitment |
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________ |
Public Relations |
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________ |
Special Projects and Events |
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________ |
Local Conservation Issues |
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________ |
Newsletter |
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________ |
Field Trip Coordinator |
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________ |
Other |
___________________________________________ |
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Membership Categories (check one) |
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Yearly ($25) |
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Membership Dues |
$ _____ |
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Scholarship Fund Donation (optional) |
$ _____ |
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Education Program Donation (optional) |
$ _____ |
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Other Donation (optional) |
$ _____ |
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Total Amount Enclosed |
$ _____ |
_______________________________________________________________________________
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Make checks payable to: DCAS |
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Mail the completed form
and check to: |
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Discovery Coast Audubon Society is recognized by the IRS as a 501(c)(3) non-profit organization. In accordance with IRS regulations, we confirm that no goods or services are provided in exchange for your donation. |