National Audubon Society Membership Application

I wish to become a member of the National Audubon Society and Fort Collins Audubon.  Send AUDUBON magazine, the Ptarmigan newsletter, and my membership card to:

NAME____________________________________________________

ADDRESS_________________________________________________

CITY_______________________ STATE________ ZIP____________

PHONE_____________________ E-MAIL_______________________

NOTE: National Audubon will not assign Windsor addresses to the Fort Collins chapter.  Windsor residents are encouraged to join Fort Collins Audubon Society independently of their National Audubon membership.

_____ Please send the Ptarmigan and other bulletins to me by regular mail.
_____ I prefer to receive the Ptarmigan via the Fort Collins Audubon website, www.fortnet.org/Audubon. Please email me when posted.

Membership type (check one):

___  $20:  Special Rate for New Membership Fort Collins Audubon D06
___  $30:  Two-Year New Membership 7XCHA
___  $15:  Senior and Student Rate
___  $35:  Renewing Member  

Did you know?... Less than $1 of your National Audubon dues is left for local funds.  Fort Collins Audubon serves National Audubon Society members through its own fundraising efforts. You can help support Fort Collins Audubon by joining independently of your National Audubon membership.

  $_____  Fort Collins Audubon Society annual dues are $15
  $_____  Additional donation to Fort Collins Audubon Society -- Thanks for your support!
     
  $_____  Total Enclosed  

Print this page, fill out the application, and send with your check payable to the Fort Collins Audubon Society to:

Fort Collins Audubon Society
P.O. Box 271968
Fort Collins, CO 80527-1968

The National Audubon Society is a nonprofit 501(c)3 organization.
Note:  Your dues include four (4) issues of AUDUBON magazine.  

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