Friends of the Lewisville Library

                                Membership Application

                    Membership will expire December 31, 2012

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.  Mailing Address:  PO Box  464, Lewisville, NC  27023

Friends of the Lewisville Library is a non-profit organization and donations are tax deductible.

** You may print this application and either mail it to the address above, along with your donation or you may turn it in at the library, along with your donation.