Just complete the attached Membership Form and return it with your check to the California State Library Foundation.

MEMBERSHIP FORM

Or please fill out form as indicated:

• Print out the application page

• Check membership category

• After printing, close this page and you will see the Foundation page still in your browser window.

• Mail form and membership contribution to:

California State Library Foundation
1225 8th Street, Suite 345
Sacramento, CA 95814-4809
Please select a category:

Associate $40.00-$99.00
Contributor $100.00-$249.00
Sponsor $250.00-$499.00
Institutional $500.00
Corporate $750.00
Lifetime $1000.00
Pioneer $5000.00

Name _________________________________
_______________
Address ____________________________________________________________________________________________________

______________________________________________________

In addition to my membership, I wish to make a contribution in the amount of:$ ____________


I wish to purchase a gift membership for: __________________________________________


I wish to make a contribution in the amount of $ _______________ in honor of / in memory of

________________________________________________________


Please send an acknowledgment of my gift membership or honoring / memorial contribution to:

________________________________________________________