Application for Gift Membership

Gift to:

Name: _____________________________________________________________________

Address: ___________________________________________________________________

City/State/Zip: _______________________________________________________________

Gift From:

Name: _____________________________________________________________________

Address: ___________________________________________________________________

City/State/Zip: _______________________________________________________________

Complete this application and mail it along with your check for $20 to Sassafras Audubon Society, P.O. Box 85, Bloomington, IN  47402.  Make check payable to Sassafras Audubon Society.