Membership Application for the Friends of the East Broad Top

Membership Application for the FEBT

Start my membership in Friends of the East Broad Top today. I've enclosed payment for the membership classification I've circled below:

REGULAR ($30*) FAMILY ($35*) SUSTAINING ($60)

ASSOCIATE ($100) LIFE ($500) STUDENT/SENIOR ($25*)

(* A $5.00 surcharge for foreign members applies.)

Please use the space below to provide us with your name and complete mailing address, as well as a summary of the payment you enclose with this membership application. If this is a gift membership, please provide the name and address of the person receiving your gift here, and provide your name and address on a separate piece of paper. Please do not send cash. Please make all checks payable to Friends of the East Broad Top.

NAME

COMPLETE MAILING ADDRESS

E-MAIL ADDRESS (if any)

Dues Amount
Please send your completed membership form (and payment) to
FEBT Membership Office
c/o Peter A. Clarke
10428 Carlyn Ridge Road
Damascus, MD 20872

FEBT Restoration Fund Donation (optional)

Total Payment Enclosed

Back to the FEBT Homepage

REGULAR ($30*)	FAMILY ($35*)	SUSTAINING ($60)
ASSOCIATE ($100)	LIFE ($500)	STUDENT/SENIOR ($25*)

NAME
COMPLETE MAILING ADDRESS


E-MAIL ADDRESS (if any)
Dues Amount		Please send your completed membership form (and payment) to FEBT Membership Office c/o Peter A. Clarke 10428 Carlyn Ridge Road Damascus, MD 20872
FEBT Restoration Fund Donation (optional)
Total Payment Enclosed