Rogue Valley
Audubon Society
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MEMBERSHIP and CHANGE OF ADDRESS
Name: _________________________________________________________
Address: _______________________________________________________
Town: __________________________ State: _______ Zip: ________-______
Phone (optional): ______________ Email (optional): _____________________
Rogue Valley Audubon Society will not share your information with any other organization.
Circle if you are a: New member Renewing member
Would you like to receive a printed copy of The Chat, our newsletter? yes no
Dues alone are not enough to support our many activities, environmental and education efforts.
Please consider a contribution in addition to your $20 membership. Your additional contribution may
be tax deductible as RVAS is a 501 (C) 3 organization.
Friend of RVAS — Up to $25
Donor — $50
Sponsor — $250
Supporter — $100
Benefactor — $500
Other $ ________
Please check here if you wish your contribution to be anonymous.
Mail this form with your check for $20 RVAS dues and any contribution you wish to make, to:
Rogue Valley Audubon Society
P.O. Box 8597
Medford, OR 97501
Rogue Valley Audubon Society
PO Box 8597
Medford, OR 97501
roguevalleyaudubon.org
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