MEMBERSHIP INFORMATION

If you wish to become a member of the "Friends of LeConte-Woodmanston" please print, complete and mail in the following form.

 

___ Sparrow (Student) $ 15.00
___ Camellia (Individual)    25.00
___ Woodmanston (Family)    35.00
___ Violet (Supporter)    100.00
___ Naturalist (Sponsor    250.00
___ Planter (Patron)    500.00
___ Steward (Benefactor)    1000.00

___

I am interested in being a Friend of LeConte-Woodmanston, but would like additional information.  Please contact me at the number below.

___

Please bill me.
Please find check enclosed.  (Make checks payable to LeConte-Woodmanston Foundation, Inc.)
Please charge my credit card account.
T    VISA                        T    MC
credit card number

____________________     exp. date __________

Signature: _________________________________________

Name:  ___________________________________________
Address:  _________________________________________
City:  _____________________________________________
Home Phone:  (     )  ________________________________
E-Mail:  ___________________________________________

Please print, complete and mail this form to:

Friends of LeConte-Woodmanston
LeConte Woodmanston Foundation, Inc.
P.O. Box 179
Midway, GA  31320
LeConte-Woodmanston Homepage