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MEMBERSHIP/DONOR FORM |
| NAME | _______________________________________________________ |
| ADDRESS | _______________________________________________________ |
| CITY | _______________________________________________________ |
| STATE | _______________________________ ZIP ____________________ |
| _______________________________________________________ | |
| DATE | __________ NEW ___ RENEWAL ___ (Check one) |
| [ ] | Individual membership | $ 15 annually |
| [ ] | Family membership | $ 20 annually |
| [ ] | Sponsor membership | $ 30 annually |
| [ ] | Benefactor membership | $ 75 annually |
| [ ] | Patron membership | $100 annually |
| [ ] | Life | $500 |
| DUES ADDITIONAL CONTRIBUTION TOTAL ENCLOSED | $__________ $__________ $__________ |
VOLUNTEER INTERESTS
My area of interest/expertise is: ________________________________________
CONTRIBUTION ONLY
Enclosed is a contribution of $__________
Contributions are tax-deductible to the extent allowable by law
All members receive the quarterly newsletter Tortoise Tracks. Please make checks payable to: Desert Tortoise Preserve Committee and mail to:
Treasurer
DESERT TORTOISE PRESERVE COMMITTEE, INC
4067 Mission Inn Avenue
Riverside, CA 92501
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