MEMBERSHIP FORM

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

Name (list all names if a family membership)

____________________________________________________________

Address

____________________________________________________________

____________________________________________________________

City/State/Zip code

____________________________________________________________

Phone

____________________________________________________________

Email

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(   ) New     (   ) Renewal

 

Type of Membership:

(   ) Senior (age 65 and over) ($5.00 / year)
(   ) Individual ($7.00 / year)
(   ) Family ($15.00 / year)
(   ) Supporter ($25.00 / year)
(   ) Patron ($50.00 / year)
(   ) Family Life Membership: $200.00
(   ) Additional Gift: $________

Are you able to help with ... ?

(   ) Pickups of Donated Books

(   ) Book Sales

(   ) Fund Raising

(   ) Other Volunteering

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