Donations of $50 and above may be
individual or joint memberships
(joint members are entitled to two
votes) __ Individual __Joint
Name
________________________________
Phone ________________
Second name (for
joint memberships)
___________________________
|
Mailing Address: |
______________________________________________________ |
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______________________________________________________ |
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______________________________________________________ |
|
eMail Address: |
______________________________________________________ |
Please charge my VISA / MC
Account #
_________________________
Expiration date:
________________
Signature
____________________
___ Please call me
to volunteer at KHLT
KHLT membership
donations are tax deductible to the
extent provided by law.
Please return to
KHLT at : 315 Klondike Ave., Homer,
AK 99603