The Fox Island Alliance
Join Us
Fox Island Alliance, Inc.
Membership Application
Name: _____________________________________
Street: _____________________________________
City, State, Zip: ______________________________
Day Phone: (______)___)_______________________
Night Phone: (______)_________________________
E-Mail: ____________________________________
Date: _____________________________________
:Please check one:
| _____ | Senior | $5 |
| _____ | Student | $5 |
| _____ | Individual | $15 |
| _____ | Family | $20 |
| _____ | Sustaining | $30 |
| _____ | Patron | $50 |
Contributions:
| _____ | Exhibit Fund | $ _____ |
| _____ | Education Fund | $ _____ |
| _____ | Scholarship Fund | $ _____ |
Check below if this membership is a gift:
_____ | This is a gift from: |
(Print your name here) ___________________________________ |
_____ I'm interested in volunteering. Please contact me.
Mail to:
Ed Powers
FIA Membership
12206 Yoder Rd,
Roanoke, IN 46783
FIA Membership
12206 Yoder Rd,
Roanoke, IN 46783
Make checks payable to: FIA, Inc.
We are a volunteer organization.
Membership dues or gifts are Tax Deductible 501C3