|
THE NEW MEXICO ENVIRONMENTAL LAW
CENTER
MEMBERSHIP FORM
Please print out, complete and mail or fax this
form as instructed below.
__YES! I want to help
protect the natural environment and communities of New Mexico with
my tax-deductible contribution.
|
Membership Levels
| __$5000.00 |
__$2,500.00 |
__$1,000.00 |
| __$500.00 |
__$250.00 |
__$100.00 |
| __$50.00 |
__$35.00 |
$______ Other |
| __$15.00 Student or Senior Membership |
|
Name ___________________________________________________________
Address__________________________________________________________
City_____________________________ State_________ Zip_________-______
Phone(______)_____________________
Email ____________________________
|
__My check is enclosed, payable to the New Mexico Environmental
Law Center (NMELC.)
__Please charge my Visa/Mastercard
Account Number_____________________
Expiration Date______________________
Name as it appears on card______________________
Signature______________________________
__My employer will match my contribution.
__Please keep my contribution anonymous.
|
|
|
Mail this form and your check to:
New Mexico Environmental Law Center
1405 Luisa Street
Suite 5
Santa Fe, NM 87505
|
|
Thank you for your
support!
|