Support FCNC



                    

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Membership Form
Thank you for your commitment to conservation of our beautiful region!
Please join us as a new member in support of the Foothills Conservancy.


Here is a printable version of this page.
Print, fill out, and mail the form to us with your check.
Renewing members may also use this link to send in membership dues or gifts.

If you would like to pay by credit card online, click on the button below
 - or, if you'd prefer to -
just fill out and send us your credit card information.
   
Membership gifts and other contributions are tax deductible.

Member Name(s)______________________________________
Address_____________________________________________
Address2____________________________________________
City___________________________________State____
Zip Code____________County(If NC)____________________
Home Phone_________________ Work Phone___________________
Fax #__________________Email_____________________________________

Please check your preferred membership level.

Horizon Society Levels
____$10,000+ Heritage
___$500+ Steward      
___$50+ Conservator
____$5,000+ Legacy
___$250+ Preserver  
___$35+ Friend   
____$2,500+ Patron      
___$100+ Protector    
____$1,000+ Benefactor






Amt. Enclosed________ Check #________

I would like to charge my gift of $____________to my (Check one) ___Visa___MasterCard
Account#___________________________Exp. Date____/_____V Code____(3 digits on back)
Pledge my gift of $____________Monthly___Quarterly___Annually___
Charge it? ___Yes___No, send me a reminder for the month of _____________, '07.

Please indicate any additional contributions which you are including with your membership gift.

General Fund $_________ Memorial/Honorary Gift $_________
In Memory of______________________ In Honor of________________________
Please Notify:
Name___________________________ Address_______________________________
City___________________State______County (if NC)________________Zip_______


Foothills Conservancy of NC
PO Box 3023
Morganton, NC  28680
Phone: 828 437-9930
Fax: 828 437-9912
Email: info@foothillsconservancy.org