Application for Membership

 

 

Name:

________________________________________________________

 

Street/RR:

________________________________________________________

 

City:

________________________________________________________

 

State:

____

Zip Code:

____________________

 

Telephone No.:

________________________________________________________

 

EMail Address:

________________________________________________________

 

 

 

Membership Donations Enclosed:

 

Individual - $5.00

Sponsor - $100.00

Family - $10.00

Patron - $250.00

Senior/Student - $3.00

Club/Corporate-$500.00

Sustaining - $50.00

Other - $

 

Legal defense fund donation  - $

(donations other than membership fees are TAX-DEDUCTIBLE)

 

Please make checks payable to:




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Thank you for your support!