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2. 
4. Today's Date*
   Today's Date
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Email address
19. Phone number(s)
21. Membership
    Membership year is January through December. Renewals are due in January. Please drop off this printed form and your membership dues (cash or check) at the library.
23. Annual Dues for: *
    Enter year here
25. Choose your membership*

    1. Individual $5
    2. Family $10
    3. Life Member (Individual or Family) $100
26. Please tell us which activities are of interest to you

    Check as many as you like

    1. Assist library staff
    2. Bookstore volunteer
    3. Help with children's activities
    4. List books for sale on Amazon.com
    5. Work on special projects
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27. Print Only

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