I want to be a Friend of the Itasca Community Library.
Name: | _______________________________________ |
| Address: | _______________________________________ |
| City & State: | _______________________________________ |
| Zip Code: | _______________________________________ |
| Telephone: | _______________________________________ |
| Email (optional): | _______________________________________ |
| I'd like to receive a copy of the monthly meetings: yes / no | |
Annual Membership Dues (circle one):
| Individual | $5.00 |
| Senior/Student | $3.00 |
| Family | $10.00 |
| Corporate | $25.00 |
| Individual/Family Patron | $25.00 & up |
| Corporate Sponsor | $50.00 & up |
| Lifetime | $100.00 |