ALAN DEVOE BIRD CLUB
MEMBERSHIP FORM

Please print this page, complete the form, and send it with your payment to:
  Sandra Williams, Membership Chair
1730 County Route 9
Chatham, NY 12037
             Please make check payable to: Alan Devoe Bird Club, Inc.

Please enroll me (us) as member(s) of the Alan Devoe Bird Club, a not-for-profit New York State
corporation 501(c)(3).
Name(s): _______________________________________________________  Date:_____________
Street: ____________________________________________________________________________
City: ____________________________ State:_____ Zip: __________ Phone: __________________
e-mail (please print clearly):___________________________________________________________

Newsletter Option:
(Check One)


  B&W paper Warbler via USPS (black ink on yellow paper)
Color eWarbler via email (faster delivery, saves postage & paper, is in color)
          Please be sure to include your email address above.

Membership Categories:
(Check One) 

 


  Adult
Junior (18 or younger)
Supporting Adult
Family/Household
Supporting Family/Household
Individual Life
$20
$10
$30
$25
$45
$500
Additional Contributions:
General Fund:_________________________
Sanctuary Fund:_______________________
Educational Opportunities Fund:__________
 
     TOTAL ENCLOSED:______________
 
Please consider supporting your club through an additional contribution.
Remember all contributions are tax-deductible.