ASCM Membership Form

National Audubon Society Local Chapter

The Audubon Society of Central Maryland

Membership Application: Please enroll me as a member of the National Audubon Society and my local chapter. Please send Audubon magazine and my membership card to this address:

Name__________________________________________________________
Address________________________________________________________
City/State/Zip____________________________________________________

Gift Membership: Please enter a one-year gift membership in the National Audubon Society and send a gift membership announcement to:

Name__________________________________________________________
Address________________________________________________________
City/State/Zip___________________________________________________

Your Name_____________________________________________________
Address________________________________________________________
City/State/Zip___________________________________________________

Membership category preferred: ___ Introductory: $20 ___ Family: $38

My check for $________is enclosed.
(Chapter code: C9ZL030Z)

Please make membership check or money order payable to: National Audubon Society

Please make contributions to assist our educational & environmental work payable to: Audubon Society of Central MD

Please mail all checks or money orders to:ASCM
P.O. Box 660
Mt. Airy, MD 21771

THANK YOU!

*National Audubon Society Local Chapter* *The Audubon Society of Central Maryland*

Membership Application: Please enroll me as a member of the National Audubon Society and my local chapter. Please send Audubon magazine and my membership card to this address:
Name__________________________________________________________ Address________________________________________________________ City/State/Zip____________________________________________________

Gift Membership: Please enter a one-year gift membership in the National Audubon Society and send a gift membership announcement to:
Name__________________________________________________________ Address________________________________________________________ City/State/Zip___________________________________________________ Your Name_____________________________________________________ Address________________________________________________________ City/State/Zip___________________________________________________
Membership category preferred: ___ Introductory: $20 ___ Family: $38
My check for $________is enclosed.	(Chapter code: C9ZL030Z)
Please make membership check or money order payable to: National Audubon Society
Please make contributions to assist our educational & environmental work payable to: Audubon Society of Central MD

Please mail all checks or money orders to:ASCM P.O. Box 660 Mt. Airy, MD 21771
THANK YOU!