FRIENDS OF THE FREEPORT MEMORIAL LIBRARY MEMBERSHIP APPLICATION

Friends of the Freeport Memorial Library is a 501(c)(3) corporation. Your donation is tax deductible under the limits of federal and state laws.

 

Please Print:

Please check Annual Membership Level: 

Individual $20 _______               Benefactor $50   ________          Corporate Matching Gift: _____________         Additional Contribution: _____________

 

Title (please circle):  Dr.     Mr.     Mrs.     Ms.     Other: _____________

 

First Name:  _____________________________________________         Last Name:  _____________________________________________________________

 

Business Name (If Corporate Membership): ________________________________________________________________________________________________

 

Street Address:  ______________________________________________   Town:  _________________________  State:  _____________   Zip:  _______________

 

Phone:  ______________________________________________  Email:  _______________________________________________________________________

 

I would like to be an ACTIVE ___   or INACTIVE ____ member.