Amigos de la Sevilleta Membership Form

You can phone in your membership to the Nature Store at 505-864-4021 or print this form and mail it with your check or credit card information to: Amigos Membership, PO Box 1248, Socorro, NM 87801

Today's Date: _______________________________

Circle: NEW membership        RENEWAL of existing membership

Mark the level of membership you are choosing. (Memberships renew January 1. If you join after June, you may take a 50% discount).

____Regular - individual - $25

____Regular - family - $45

____Turquoise - $100

____Golden Eagle - $250

____Senior (over 65) - $20

____Senior family - $35

____Student (with ID) - $10

____Life membership - $1000
(not discounted)

 

First Name______________________________ Last Name ____________________________________

email (please print carefully) _____________________________________________________

phone_________________________________

Mailing address ________________________________________________________________________

address line 2 (if needed) _______________________________________

State______ Zip __________