National Audubon Society

Membership Enrollment Form

Name

Address

City

State

Zip

Telephone

Select membership option:

___ One-year individual/family membership ($20)

___ Two-year individual/family membership ($35)

___ One-year senior/student membership ($15)

___ Chapter only membership (see below)

Chapter Code: N53 7XCH

Make check payable to National Audubon

Society and mail with this form to:

National Audubon Society

Membership Data Center

P. O. Box 51001

Boulder, CO 80323-1003

Chapter Only Membership--You may join the Five Valleys Audubon Society only. One-year chapter membership dues of $15 include the Birding Observer and participation in all chapter activities. Dues remain with this chapter. To join, print and complete this form. Mail the form with a check made payable to Five Valleys Audubon Society to:

Five Valleys Audubon Society

P. O. Box 8425

Missoula, MT 59807