Membership Application

Address Information:

Name: _________________________________________________

Address: _______________________________________________

City, State, Zip Code:_____________________________________

Phone:___________________ E-mail:_____________________

Check if this is a new address.

Dues (Circle one): Your dues bring you news and events on a regular basis, and help to sustain the operations of our laboratory.

$10 - Student	$50 - Sustaining
$20 - Individual	$100 - Corporate
$30 - Family

I would like to volunteer for:

Water monitoring	Riverfest
Office support	Water quality lab

Payment: You may print out this form and mail along with payment to FOSR.

Make checks payable to:

The Friends of the Shenandoah River
P.O. Box 410
Front Royal, VA 22630

FOSR is a non-profit organization and all contributions are tax deductible.

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