Friends of Steele Creek Nature Center and Park

Application for membership

Name:  _____________________________________

Address:  ___________________________________

City:  ______________________________________

State:  ______________  Zip:  __________________

Home Phone:  _______________________________

Work Phone:  _______________________________

E-mail:  ____________________________________

Membership Category:

______  Individual $10
______  Family $20
______  Student $5 (Primary, secondary
	       or full-time college enrollment
______  Senior $5 (65 years or older)
______  Patron $50
______  Sponsor $100
______  Benefactor $500

Addtional Donation:  _________________

ALL CONTRBUTIONS ARE TAX DEDUCTIBLE

Mail to:

Friends of Steele Creek
Nature Center and Park
P.O. Box 1763
Bristol, TN 37621-1763