California State Library Foundation

Just complete the attached Membership Form and return it with your check to the California State Library Foundation.

MEMBERSHIP FORM

Or please fill out form as indicated:

• Print out the application page

• Check membership category

• After printing, close this page and you will see the Foundation page still in your browser window.

• Mail form and membership contribution to:

California State Library Foundation
1225 8th Street, Suite 345
Sacramento, CA 95814-4809
Please select a category:

	Associate $40.00-$99.00
	Contributor $100.00-$249.00
	Sponsor $250.00-$499.00
	Institutional $500.00
	Corporate $750.00
	Lifetime $1000.00
	Pioneer $5000.00
Name ________________________________________________
Address ______________________________________________ ______________________________________________________ ______________________________________________________
In addition to my membership, I wish to make a contribution in the amount of: $ ____________ I wish to purchase a gift membership for: __________________________________________ I wish to make a contribution in the amount of $ _______________ in honor of / in memory of ________________________________________________________ Please send an acknowledgment of my gift membership or honoring / memorial contribution to: ________________________________________________________