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Printable                Mail-in Membership Form
Version            for Sierra Club Membership F94QE04741

Name: ____________________________________________________________________________

Address:  __________________________________________________________________________

Phone: _____________________ Fax: ________________________

Email: __________________________________________________

  Please select a membership level:
  Please select a payment method:
 Individual Membership  Joint Membership  Check: ___  Payable to "Sierra Club"
 ___ Introductory $25    AMEX: ___ 
 ___ Regular $39  ___ Regular $47  Mastercard: ___
 ___ Supporting $75  ___ Supporting $100  Visa: ___
 ___ Contributing $150  ___ Contributing $175  
 ___ Life $1000  ___ Life $1250 Card No: _____ _____ _____ _____
 ___ Student $24  ___ Student $32  
 ___ Senior $24  ___ Senior $32  Exp Date (mm/yy): ________
 ___ Limited Income $24  ___ Limited Income $32  

Mail to:

Sierra Club Member Services 85 Second Street, 2nd Floor San Francisco, CA 94105-3441
Thank you!

Contributions, gifts and dues to the Sierra Club are not tax deductible; they support our effective, citizen-based advocacy and lobbying efforts. Your dues include $7.50 for your subscription to Sierra Magazine and $1 for your Chapter newsletter