MEMBERSHIP APPLICATION
Shreveport Society for Nature Study, Inc.
BIRD STUDY GROUP

318-797-5338

E-mail:

Please print this page, complete items listed in table below, and enclose check for desired level of membeship.

Name:
Address:
City: State: Zip:
Home Phone: Work Phone:
E-mail address(es):  

Do you wish to be added to the Bird Alert Service?
(e-mail notification of bird sightings - requires e-mail address above)

 Yes No (Please check one)


Do you wish to be included in the Membership Directory?
(periodically published members only directory)

 Yes No (Please check one)


How did you find out about us?

 Phone Book

Bumper Sticker

Newspaper

Web Site

Word-of-mouth

Newsletter

Magazine

Other



Membership Level Desired:

Individual $15.00 Family $20.00 Sustaining $35.00

(Please check one)

Donation Use Designation:

 Library

 Refuges

 Refreshments

 Where most needed
 (Please check one)


Make checks payable to: SSNS- Bird Study Group
Mail applications to:

SSNS-Bird Study Group
One University Place
Shreveport, LA 71115-2399

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