Contact Information:
Discovery Coast Audubon
Society
P. O. Box 724
Long Beach, WA 98631
360-642-1310
Membership Form 7XCH Y27 |
| (Print out, fill in, and mail with your check to address below) |
| Name: ____________________________ |
| Address: __________________________ |
| City, State, Zip: ____________________ |
| Phone: ___________________________ |
| E-mail:___________________________ |
| Add you to our e-mail list? | ___ Yes | ___ No |
| Volunteer Interests (check interests) |
| ___ | Environmental Education |
| ___ | Fund Raising |
| ___ |
Membership Recruitment |
| ___ | Public Relations |
| ___ | Special Projects and Events |
| ___ | Local Conservation Issues |
| ___ | Newsletter |
| ___ | Field Trip Coordinator |
| ___ | Other | ___________________________ |
| Membership Categories (check one) |
| ___ | Yearly ($25) |
|
Membership Dues
|
$ _____ |
|
Scholarship Fund Donation
(optional)
|
$ _____ |
|
Education Program
Donation (optional)
|
$ _____ |
|
Other Donation (optional)
|
$ _____ |
|
Total Amount Enclosed
|
$ _____ |
| Make checks payable to: DCAS |
|
Mail the completed form
and check to: |
| Discovery Coat 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. |