SRS HERITAGE FOUNDATION

MEMBERSHIP APPLICATION

 

I would like to become a member of the SRS Heritage Foundation in the following level. (Please Check One)

Corporate$1,000.00
Small Business$250.00
Benefactor$120.00
Patron$60.00
Sustaining$35.00
Student$15.00

I would be willing to help with Publications, Membership, Fundraising, Publicity, other _____________________________

     (Please fill-in category you would like to help in)

Name:

 

 

Address:

 

 

City, Zip Code:

 

 

Phone:

 

 

Email:

 

 

Fax #:

 

 

My check, made out to the SRS Heritage Foundation, Inc. is enclosed. (Contributions to the Foundation are tax-exempt.)

 

Please mail to:

J. W. Joseph

340 Cherbourg Place

Aiken, SC 29801

Phone:  (803) 648-5634

Email: qualityprt@aol.com