San Carlos Friends of the Library Application

(please print)

Name (Ms./Mr./ Mrs./ Mr. & Mrs.)________________________

Mailing Address:_____________________________________

e-mail Adress:______________________________________

Daytime Phone:__________ Evening Phone:____________

Date:_________________New:______Renewal:_______

Please check one:

Sponsor ($25.00):____ Family ($10.00):________

Adult ($5.00):______ Senior ($3.00): ________

Special Gift($)__________________________

Individual Contributors of $250.00 or more shall be entitled to a Life Membership.

Individual Life Member ($250):___ Benefactor ($500):_____

Patron ($1000):____ Contributor/Business ($100.00)______

My company ________________________________matches gifts.

In Memory Of

I/We wish to make a gift in honor/in memory of:

____________________________________________.

Make your application and tax-deductible check payable to SCFOL. It may be dropped off at the San Carlos Branch Library or mailed to:

SCFOL Membership

7265 Jackson Drive

San Diego, Ca 92119-2314