| Type Contribution | Amount | Check |
|---|---|---|
| STUDENT Admission to Programs plus newsletter | $ 1-10 | _____ |
| FAMILY/HOUSEHOLD Admission to Programs plus newsletter | $ 20 | _____ |
| CONTRIBUTOR (or volunteer service) Admission to Programs plus newsletter | $ 15 | _____ |
| SPONSOR (or volunteer service) Admission to Programs plus newsletter | $ 25 | _____ |
| SUSTAINING ADVISOR (or volunteer service) Benefits above plus Advisor to Advisory Council | $ 50 | _____ |
| BENEFACTOR Benefits above plus Commemorative gift | $ 100 | _____ |
| ****************************************************** | ||
| BUSINESS FRIEND Admission to Programs for Representative | $ 100 | _____ |
| CORPORATE SPONSOR Admission to Programs for Representative plus newsletter | $ 200 | _____ |
| CORPORATE BENEFACTOR Benefits above plus State Park Passport AND Commemorative Gift | $ 500 or more | _____ |
| Signature:___________________________________ | ||
| Date:_______________________________________ | ||
| Name:______________________________________ | ||
| Address:____________________________________ | ||
| City, ST, Zip:_________________________________ | ||
| Telephone:___________________________________ |
Send an E-mail |