MEMBERSHIP DUES FORM

(Membership year is January 1–December 31)

Please type or print

Name ____________________________________________________________________________

Organization/Firm ___________________________________________________________________

Address __________________________________________________________________________

City/State/Zip ______________________________________________________________________

Phone Fax ________________________________________________________________________

 

Check type of membership:

ORGANIZATION MEMBERSHIP: $100 - This entitles an organization or business to participate as a voting member in AITC  meetings and activities. Please designate the name of the individual who will represent your organization or business. This individual will receive all mailings on behalf of the membership unless we are otherwise informed.

 

INDIVIDUAL MEMBERSHIP: $50 - This entitles an individual to participate as a voting member in AITC meetings and activities.

 

DONATION: A generous gift from an individual, business or organization for the continuation of the AITC program.

 

_______________________________________________________________________________________________________

Print this page out, Then send it in to the below address.
Please make checks payable to Idaho Ag in the Classroom Association.

This form and check may be returned to: Idaho Agriculture in the Classroom Association
                                                                      55 SW 5th Ave, Suite 100
                                                                      Meridian ID 83642
                                                                      PH: 208-888-0988 FX: 208-888-4586

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