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MEMBERSHIP APPLICATION
Name:__________________________ Email:_____________@______________
Telephone #:(_____)___________________
Street/Mailing Address:_______________________________________________
City:____________________________ Zip:_______________________________
Please check (a) in the appropriate box to indicate if this is a:
New Membership [_] or Renewal [_]
Designate your choice of membership by placing a check (a) near your selection.
Student $1.00 /yr. Individual $5 /yr. Sponsor $10 /yr. Patron $30 /yr. Corporate $100 /yr. Life- One time donation of $100 or more If you would like to become a Volunteer, please indicate here_____(a).
Mail or bring this form and a check made out to: Friends of the M/S Library Mims/Scottsmoor Public Library 3615 Lionel Road Mims, FL 32754 "Libraries are not made; they grow"
