| Friends of the Cowlitz Membership Form |
Check One Category You Will Receive
_____ $30.00 Regular Member Membership card, FOC decal and newsletter for one
year
_____ $100.00 Individual Sponsor Membership card, hat, FOC decal
and newsletter for one year
_____ $500.00 Corporate Sponsor Membership card, hat, FOC decal,
newsletter and Free Ad for one year
_____ $2000.00 Benefactor Membership card, hat, FOC decal,
FOC patch and newsletter for life
_____ $20.00 Senior Member Membership card, FOC decal and
(birthdate__________) newsletter for one year
_____$20.00 Junior (age 14 & under) Membership card, FOC decal and
(birthdate___________) newsletter for one year
_____ 501C3 - $ Tax Deductible Contribution
(enter amount)
_____ Renewal Credit Card #_____________________Exp. Date__________
_____ New Member Recruited by: ____________________________(member)
Name ____________________________________
Address __________________________________ City___________________
State __________________ Zip____________ Telephone( )
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FOC Activities in which I would like to participate:
Fund Raising /raffle ticket sales ____, Kids Free Fishing Trout Pond ____,
Fish Rearing (net pen project) ____, Annual Easter Egg Hunt ____
Please return this application, along with payment or credit card information
to:
Friends of the Cowlitz. - P.O. Box 248, Salkum, WA 98582