Application for Membership in RPRA/Donation

Name_________________________________Address_______________________________City__________________________________ State_________________________________Zip Code__________Phone________________

 

Mail to:

Rollins Pass Restoration Association
P.O. Box 1082
Longmont, Colorado 80502-1082

All donations and membership dues are tax deductible, 501 (C)3 Non-Profit Corp.

• A donation of $1000 will make you a RESTORER in RPRA and you will receive a plaque and a lifetime membership.

• A donation of $500 will make you a BENEFACTOR in RPRA and you will receive a plaque with your name and date of donation.

• A donation of $250 will make you a PATRON in RPRA and you will receive a plaque with your name and date of donation.

• A donation of $100 will make you a CONTRIBUTOR in RPRA and you will receive a certificate with your name and date of donation.

Membership Year: May 1st to April 30th

__$12 Individual Membership

__$12 Non-Profit OrganizationMembership

__$15 Family Membership

__$50 Business Membership

__$200 Lifetime Membership