MEMBERSHIP APPLICATION

Page Last Revised: 10/17/2009

Right Click Mouse Button Select Print

Please print this page and mail to:

 

ECOS: The Environmental Clearinghouse, Inc.

PO Box 9118

Niskayuna, New York 12309

Please check your membership contribution level:

__$30 Individual                   __$40 Family                   __$55 Donor

__$125 Sustainer                  __$250 Benefactor           __$ Additional Donor

Please make checks payable to ECOS:

Name:_____________________________________________________

Address:___________________________________________________

Phone:________________________  Email:_______________________

__As a GE employee or retiree my contribution is eligible for GE Foundation Matching funds. I have called 1-800-305-0669 to register this gift. (When you call, GE will ask you for your social security number and ECOS's zipcode 12309)

 

__My employer will match my contribution. I've enclosed a matching gift form.

 

__I would like information on volunteer opportunities. Please send me information.

Membership Level            New Dues             Benefit

Individual                            $30.00                   Newsletter, Reduced program fees

                                                                           10% publications discount if 

                                                                           purchased at ECOS     

 

Family                                  $40.00                  All of the above PLUS

                                                                           A free event under $5 for each family

                                                                           member when attended as a family

 

Donor                                   $55.00                  All of the above PLUS

                                                                           Two free events under $5

 

Sustainer                              $125.00                All of the above PLUS

                                                                           one free publication (choice of 

                                                                           wildflower guide or bike trail guide)

 

Benefactor                           $250.00                All of the above PLUS

                                                                           One free ticket to annual dinner

 

Renewals at the family level will receive vouchers for program attendance

  


To top of page