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