Online Membership Form

Friends of Five Rivers Membership

Membership

Annual Dues *

Student/Senior - $ 25.00

Individual - $ 35.00

Family - $ 50.00

Patron - $ 100.00

Benefactor - $ 200.00

Sustainer - $ 500.00

Please renew my membership automatically.

Total Amount

Email Address *

Member Information

First Name *

Last Name *

Address *

Address Line 2

City

State *

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 *

State/Province

Postal Code

Additional Information

How did your hear about Friends?

I'd like to receive updates from friends

Mailing List

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I'd like to receive information on volunteer opportunities

Volunteer Opportunities

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Please include my name and support in Friends’ Annual Report.

Included in Annual Report