To join: Print, complete, and mail this form with payment to:

      San Mateo Bird Alliance
      Attn: Membership Committee
      P.O. Box 620292
      Woodside, CA 94062-0292

Check appropriate box [  ] below.

[  ] San Mateo Bird Alliance individual membership: $25.00
[  ] San Mateo Bird Alliance family membership: $45.00
[  ] San Mateo Bird Alliance Senior (>62)/Student (<25) membership: $20.00
[  ] San Mateo Bird Alliance Supporter membership: $100.00


Local chapter members are eligible to receive the SMCBA newsletter, 
with current information on field trips, meetings and other activities.  
Let us know if you'd like the newsletter by mail or email.
By selecting chapter membership, all of your dollars will be used to 
support local programs.  

[  ] Donation: $___________ we appreciate your tax-deductable 
    donation which helps fund the chapter's education, conservation 
    and on-going recreational activities.


Name:    _________________________________________________________


Address: _________________________________________________________


City:    _________________________________________________________


State:   _________ Zipcode: _____________ Phone: _________________

Email 
adress:	 _________________________________________________________

Also:

There are _____ member(s) in my household.  


Needles Newsletter Preference: [  ] mail and/or [  ] email.


[  ]  Yes!  I am interested in volunteering.  I may be able to help with:


    _________________________________________________________