| Print out this page and mail it with your membership check payable to
the address listed next to the option you choose: |
Yes! I am interested in becoming a member in the |
|
Great South Bay Audubon Society |
|
(Please Check Appropriate Lines - Note: You can select both options if you wish.) |
Please establish a one year membership for:
|
| Option A: ________ National
Audubon Society |
You will also automatically be a
member of Great South Bay Audubon Society (“GSBAS”), the local Chapter.
You will receive Audubon magazine and the “Sandpiper.” GSBAS gets $20.00
for each new membership contribution.
Please make checks for Option A
payable to: “National Audubon” and send this form to National
Audubon Society, P.O. Box 422250, Palm Coast, FL 32142-2250.
New Membership $20 _______ Senior $15 _________
|
| Option B: ________ Great South Bay Audubon Society (“GSBAS”) and “Friends of Brookside” |
You will be a member of GSBAS
and you will receive the “Sandpiper.” Your contribution will support
GSBAS and our work at Brookside County Preserve.
Please make checks for Option B payable to: “Great South Bay
Audubon Society” and mail to GSBAS, P.O. Box 267, Sayville, NY 11782.
New Member Introductory Contribution $20 _______ Renewal $35
_________
Senior $15 __________ Senior Renewal $15 ___________ |
|
C0ZR110Z |
Your Contact Information
|
Name_____________________________________________________________
Address___________________________________________________________
City ___________________________ State _____________ Zip _____________
Telephone ________________________ Email Address _____________________ |
