Membership Application
I would like to be accepted as a member of the Mt. St. Helens Preservation Society. I pledge to respect and uphold the laws and rights of all individuals at all times. I agree to follow all Mt. St. Helens Preservation Society guidelines and rules. I will conduct myself in a professional, orderly manner at all times.
NAME: __________________________________________
ADDRESS:_______________________________________
CITY: ___________________________________________ STATE: ____________ ZIP: __________
PHONE: __________________ FAX: ________________
E-MAIL: _________________________________________
ARE YOU A REGISTERED VOTER? Yes / No
Membership fee of $25 attached. ___
I would like to make an additional tax deductible donation of: $_________ |