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