Join Audubon printable form

MEMBERSHIP APPLICATION — Rogue Valley Audubon Society

Name: _________________________________________________________

Address: _______________________________________________________

Town: __________________________ State: _______ Zip: ________-______

Phone (optional): ______________ Email (optional): _____________________

Rogue Valley Audubon Society will not share your information with any other organization.

Check applicable box: New member    Renewing member

Dues alone are not enough to support our many activities, environmental and education efforts. Please consider a contribution in addition to your $20 membership. Your additional contribution may be tax deductible as RVAS is a 503C organization.

Friend of RVAS—Up to $25       Sponsor—$250

Donor—$50       Benefactor—$500

Supporter—$100       Other $ ________

Please check here if you wish your contribution to be anonymous.

Mail this form with your check for $20 RVAS dues and any contribution you wish to make, to Rogue Valley Audubon Society, P.O. Box 8597, Medford, OR 97504.

Friend of RVAS—Up to $25	Sponsor—$250
Donor—$50	Benefactor—$500
Supporter—$100	Other $ ________