UUAM MEMBERSHIP FORM

Yes, I wish to join UUAM:

___ $30 Henry Bergh (Member)
___ $75 Clara Barton (Humanitarian)
___ $200 Charles Darwin (Visionary)
___ $500 Rachel Carson (Earth Guardian)
___ $1000 Albert Schweitzer (Lifetime Member)
___ UUAM Chapters/Organizations: $100 (fees may be waived or
      reduced at UUAM President's Discretion)
___ Additional donation: $____________

My check is enclosed for $____________

___ I would like to be on the UUAM mailing list.

___ I would like to be linked with other UUAM members on the internet.

Name: ________________________________________
 
Address: ________________________________________
 
Email: ________________________________________
 
UU Society: ________________________________________

Please mail your check, payable to UFETA, to:

UU Animal Ministry
c/o Pat Tullo, Treasurer
11744 295th Street Way
Welch, MN 55089-4106

Membership in this non-profit, tax-deductible organization is open to any person who supports our principles, purposes and goals.