Sierra Club

Membership Form

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To become a member of The SIERRA CLUB, print a copy of this form, fill it out and mail your check, payable to The SIERRA CLUB, to:

Fred Adams
1548 Edgewater Drive
Virginia Beach, VA 23464

If you would like to make an additional contribution to The SIERRA CLUB, indicate the amount (______) and include this on your check in addition to your membership fee. Thank you.

MEMBERSHIP CATEGORIES
Please check category.
Category Individual Joint
Introductory $25(__)  
Regular $39(__) $47(__)
Supporting $75(__) $100(__)
Contributing $150(__) $175(__)
Life (in full) $1,000(__) $1,250(__)
Student $24(__) $32(__)
Senior $24(__) $32(__)
Limited
Income		 $24(__) $32(__)
Your dues include $7.50 for a subscription to SIERRA Magazine, and $1.00 for your chapter newsletter.

Your Name _______________________________________

Mailing Address _________________________________

City/State/Zip ___________________________________________________

Telephone # ________________________

E-Mail address ________________________