Membership gifts and other contributions are tax deductible.

Member Name(s)______________________________________
Address_____________________________________________
Address2____________________________________________
City___________________________________State____
Zip Code____________County(If NC)____________________
Home Phone_________________  
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 $_________
___Visa___MasterCard__AMEX__Discover
Account#___________________________
Exp. Date____/_____
V Code____(3 or 4 digits on back)

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