Friends of the Lewisville Library

Membership Application

Membership will expire December 31, 2010

Date____________________  

 Circle Appropriate Response 

                        Renewal                 New Member              Donation

Individual Student of Senior Citizen (55 years +)              $5 

Individual                                                                               $10

Family                                                                                   $20 

Business                                                                                $25 

Lifetime                                                                                 $200 

Donation                                                                              _______ 

Name________________________________________________________ 

Mailing Address________________________________________________ 

City, State. Zip Code____________________________________________ 

Home Telephone _______________________________  Cell ___________ 

E-Mail _______________________________________________________ 

Employer(s) _________________________________(Matching funds possibilities) 

Interested in Helping?       Book Sale        Programs        Publicity          Receptions

                                          Children’s Programs           Fund Raising       Telephoning 

Questions, Comments, Suggestions:_______________________________________ 

____________________________________________________________________ 

Please make checks payable to Friends of the Lewisville Library and mail to PO Box  464, Lewisville, NC  27023 or drop at the library.  Friends of the Lewisville Library is a non-profit organization and donations are tax deductible.