Friends of Five Rivers Membership Membership Annual Dues * Individual - $ 35.00 Family - $ 50.00 Student 18+ - $ 25.00 Older Adult 62+ - $ 25.00 Veteran - $ 20.00 Patron - $ 100.00 Benefactor - $ 200.00 Sustainer - $ 500.00 Please renew my membership automatically. Membership will renew automatically. Total Amount Email Address * Member Information First Name * Last Name * Address * Address Line 2 City State * - select State/Province - Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northern Mariana Islands Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Zip Code * Home Phone * Cell Phone My billing address is the same as above Billing Name and Address Billing First Name * Billing Middle Name Billing Last Name * Street Address * City * Country * - select - United States Canada State/Province - select State/Province - Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas United States Minor Outlying Islands Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Postal Code Additional Information How did your hear about Friends? - select How did your hear about Friends? - Internet Search From a friend Mailing Other I'd like to receive updates from friends Mailing List Yes No I'd like to receive information on volunteer opportunities Volunteer Opportunities Yes No Please include my name and support in Friends’ Annual Report. Included in Annual Report - select Included in Annual Report - Include Do Not Include Review your contribution
