Supporting Member Form
***PLEASE PRINT THIS FORM OUT AND SEND IT WITH THE APROPRIATE DONATION TO:
Nuestras Raíces
245 High Street
Holyoke, MA, 01040
Donor Information (please print or type)
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Membership Information (Circle)
Which membership have you joined?
“El Cuatro” “Flamboyan”
What level have you joined?
Shirt Size: S M L XL XXL
Issues most interested in:
Environment Economic Development Culture
Youth Food Systems/Agriculture
I (we) pledge a total of $ to be paid now.
CASH
CHECK#_______
Acknowledgement Information
Please use the following name(s) in all acknowledgements:
I (we) wish to have our gift remain anonymous.
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Date |
***Note that our memberships begin at the first of every month.
FOR EXAMPLE if we recieve you generous donation the 23rd of October, your membership benefits will begin and be shipped to you on the 1st of November.
