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INDIVIDUAL MEMBERSHIP
First Name:
Last Name:
E-mail Address:
Mailing Address:
City:
State:
Zip Code:
Phone (Home):
Phone (Work):
Fax:
Institution:
Position:
Institution Address:
Select Membership Level:

  Castle Hill  13feet  Senior over 62: ($20) 

  Krestoff Mountain 1598 ft  Under 25: ($20)

  Gavan Hill  2530 ft   Individual: ($40)

  Gross Mountain  3031 ft   Family: ($50)

  Arrowhead Mountain  3048 ft   Donor: ($100)

  *Mount Verstovia  3117 ft  Business: ($250)
*Business Membership includes link on our website
  Three Sisters  3599 ft  Sustaining: ($1000)

 Mount Katlian  3999 ft   Benefactor: ($5000)

Please enter an amount: $ 

Your membership is valid for one calendar year only, from January 1 to December 31.
ADDITIONAL CONTRIBUTIONS:

I'd like to contribute to the advocacy fund. Please add $    to my membership payment.

I'd like to contribute to the ???? Fund. Please add $    to my membership payment.
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