Chapter-only Membership Form: Topeka Audubon Society

Please print out this page and send it to Topeka Audubon Society, PO Box 1941, Topeka, KS 66601. Make the check payable to "Topeka Audubon Society." All your funds are used locally! Benefits of membership: Subscription to the chapter newsletter, educational programs, and birding field trips twice per month. 

O – Yes, make me a member of Topeka Audubon	(check those that apply)
O  $15 One-year Student membership
O  $18 One-year Individual membership
O  $25 One-year Family membership
O  $30 One-year Organization membership	Additional gift to Topeka Audubon Society:
O  Check if this is a renewal	O $10    O $25   O $50   O $100   O $ ________

                 Total: _______

Make check payable to: Topeka Audubon Society Mail to: Topeka Audubon Society PO Box 1941                Topeka KS 66601 Questions: Call Name at (785) xxx-xxxx	O Enclosed is a personal check or money order
	O Please bill my:         O Visa          O MasterCard
	Card #: _________________________  Exp. date: _______
	Signature: ______________________________________
	Print name: ______________________________________

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Phone
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Please make this a gift membership to the recipient described below:

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City	State:	Zip:
Gift Message