Fill in your mailing information, print this page, and mail your application with a check (payable to “Audubon”) to the address below.

Member Information

Full Name: ______________________________

Email Address: ______________________________

Mailing Address: ______________________________

______________________________

City: ______________________________

State: ______________________________

Zipcode: ______________________________

Chapter Affiliation

Chapter Code: C2Z C53 0Z (Eastern Sierra Audubon)

How did you hear about us?

▢ Brochure ▢ Newsletter ▢ Website ▢ Email ▢ Other – Where?______________________________

Privacy

▢ Please do not share my contact information with other organizations

Options

I would like to have National Audubon Society contact me to discuss:

▢ Planned Giving ▢ Paperless Renewals ▢ Giving a Membership Gift

Mail with check to:

Eastern Sierra Audubon Society
PO Box 624
Bishop, CA 93515