
Mail-in Membership Form
for Sierra Club Membership F94QE04741
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
City: _________________________________ State: ___________________ Zip Code:_______________
Phone: _____________________ Fax: ________________________
Email: __________________________________________________
May we correspond with you via e-mail? Yes: ___ No: ___
From time to time, we make our mailing list available to other worthy
organizations. If you prefer that your name not be included,
please check here: ___
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Please select a membership level:
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Please select a payment method:
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| 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 | |
When you join the Sierra Club you will have the satisfaction of knowing that you are helping to preserve irreplaceable wildlands, save endangered and threatened wildlife, and protect this fragile environment we call home. You can be sure that your voice will be heard through congressional lobbying and grassroots action on the environmental issues that matter to you most. Thank you for your contribution.
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. (Additional financial and regulatory information.)