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:  (Rates are effective January 1, 2009)

Sponsor ($50.00):____

Family  (dual adult) ($20.00):________

Adult ($10.00):______

Senior / Youth < 18 yr. ($5.00): ________

Special Gift($)__________________________

Individual Contributors of $500.00 or more shall be entitled to a Life Membership.

Individual Life Member ($500):________  

Patron ($1000):__________

Contributor/Business ($100.00)______

My company ________________________________matches gifts.

In Memory Of

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

____________________________________________.

Note:  If you have any special type of book or a particular author you would like to request, please note that here.

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