Call us at 541.461.2156 or fax/mail this form:
$35--Standard Member
$50--Supporter
$60--International Member
$100--Contributor
$500--Conservator
$1000--Sponsor
$2500--Benefactor
$5000--Advocate
$10,000--Trustee
Other Amount:
Name:
Email:
Street Address:
City:
State/Province:
Country:
Zip Code:
-
Message Box:
Method of Payment:
Visa
Mastercard
Card Number:
Expiration Date:
month/year:
1. Print this form (go to your browser's "File" menu and click "print").
2.
Mail or fax it to us at:
fax:
541.461.2156
U.S.P.S.
P.O. Box 2190, Eugene, OR. 97402
