2010-2011 APAS
Membership Application

(Sept 1, 2010 to Aug 31, 2011)









Click here to return to the Contacts & Membership Page.
To become a member of the Allegheny Plateau Audubon Society, print and complete this application form and send it with the appropriate dues to this address.
Allegheny Plateau Audubon Society, c/o Bob Stewart,  257 Kring St, Johnstown, PA 15904
 

Name  _________________________________________________

Address ________________________________________________

            _________________________________________________

City _______________________________ County______________

State _____________________________     ZIP ________________

Telephone  (      ) _____________________________________

e-mail  __________________________________________________

If you wish to receive occasional news bulletins and event reminders by email, circle this statement to join the APAS Bulletins email list. 

Circle how you wish to receive the "Chickadee Chatter", the APAS newsletter:

     I want a paper copy of the newsletter sent to my physical address      

     I want the newsletter electronically sent to my email address (this saves us mailing costs)

NATIONAL MEMBERSHIP (includes local chapter membership make checks payable to: National Audubon Society)          

            ____ I am a new member ($20 check)

            ____ I am renewing my membership ($35 check)

            ____ I am renewing my membership, but address has changed

CHAPTER MEMBERSHIP ONLY (make checks payable to: Allegheny Plateau Audubon Society)

 ___ I am a new member- chapter only ($15 check)

____ I am renewing my membership- chapter only ($15 check)

I am including a $ _______donation to the Allegheny Plateau Audubon Society

http://www.alleghenyplateauaudubon.org                                                                   C9ZU200Z