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Umstead Coalition Membership Form

(PLEASE PRINT)

Print this form.

Complete and return this form with a check for the $15.00 membership fee and any donation, to:

The Umstead Coalition, P.O. Box 10654, Raleigh, N.C. 27605-0654. (919) 852-2268

Name:

Date:

Street:

City:

State:

Zip:

Telephone (w)

(h)

Email:

Umstead Coalition Organizations you belong to (if any):

Would you like to attend our meetings?

Please check the activities in which you would like to participate:

Land Acquisition

Duraleigh Connector Opposition

Leading hikes

Environmental Education

Park Service Projects

Protecting Richland Creek area

Attending Public Meetings

Celebration for Umstead

Other:

Membership ($15):

Additional Donation:

Amount enclosed $

rev. 3/27/01

Print this form. Complete and return this form with a check for the $15.00 membership fee and any donation, to: The Umstead Coalition, P.O. Box 10654, Raleigh, N.C. 27605-0654. (919) 852-2268
Name:		Date:
Street:
City:	State:		Zip:
Telephone (w)		(h)
Email:
Umstead Coalition Organizations you belong to (if any):
Would you like to attend our meetings?
Please check the activities in which you would like to participate:
Land Acquisition		Duraleigh Connector Opposition
Leading hikes		Environmental Education
Park Service Projects		Protecting Richland Creek area
Attending Public Meetings		Celebration for Umstead
Other:

Membership ($15):
Additional Donation:
Amount enclosed $