Collier County Audubon Society Membership Application Instructions: Type it -- Print it -- Mail it
C O L L I E R . C O U N T Y . I N F O R M A T I O N
LAST name:			FIRST name:	MI
Street address:			City, State, Zip:
Phone:	h w		e-mail:
S U M M E R . A D D R E S S ( only if different from above)
Street address:			City, State, Zip:
<> <> Change over dates <> <>
to Collier County:	month day		to summer address:	month day
P A Y M E N T . I N F O R M A T I O N
Please check one:	One-year new membership ($20) Two-year membership ($34.95) Three-year membership ($44.95) Seasonal Snowbird 1-year membership ($10)		and, please check if this is a renewal of current membership
	Make check payable to:		National Audubon Society (please write the chapter code -- E38 -- on the check's memo line)
	Print out and mail with your check to:		Collier County Audubon Society attn: Lori Beall 1020 8th Avenue South, Suite 2 Naples, FL 34102
A D D I T I O N A L . I N F O R M A T I O N
Please check one: I prefer to receive the Collier County Audubon Society Newsletter Audugram by e-mail, or by postal mail
For more information or for questions, call (239) 643-7822 or email
E38			7XCH