| Junior membership (16 years or younger) |  |
$5 |
| Individual membership | |
$20 |
| Family membership | |
$35 |
| Contributing membership | |
$75 |
| Other | |
_____ |
| Check if renewing your membership | |
Bastrop County Audubon
Society
Membership Application
Enclosed are my annual dues in the amount indicated below. Please enroll me as a member of Bastrop County Audubon Society.
Junior membership (16 years or younger) $5 Individual membership $20 Family membership $35 Contributing membership $75 Other _____ Check if renewing your membership
Name __________________________________________
Date of birth (if Junior Member) _____/_____/_____
MM DD YYYY
Address ________________________________________
City, State ZIP ___________________________________
Phone __________________________________ (Optional)
Email ___________________________________(Optional)
Please contact me about volunteer opportunities ______
Please make your check payable to: Bastrop County Audubon Society
Print this form, fill it in and mail it with your check to:
Bastrop County Audubon Society
c/o Alan Jaeger
117 Kaelepulu Dr.
Bastrop, TX 78602-7221
This page was last updated on Wednesday September 15, 2010 03:47 PM