MEMBERSHIP FORM

Yes, I would like to support the Crockett Library by becoming a member of the Friends of the Crockett Library.

Name

____________________________________________________________

Street Address

____________________________________________________________

____________________________________________________________

City/State/Zip code

____________________________________________________________

Phone

____________________________________________________________

Email

____________________________________________________________

(   ) New     (   ) Renewal

 

Type of Membership:

(   ) Individual ($5 / year)
(   ) Organization ($10 / year)
(   ) Contributor ($25.00 / year)
(   ) Additional Gift: $________

Are you able to help with ... ?

(   ) Pickups

(   ) Sales

(   ) Phone

(   ) Sorting

Please send this form along with your check or money order for your dues to: