You can use this page as a membership application. Just print out the form and fill in the requested information. You may also use the link below to download the document for printing. To download the file, you will need to have Acrobat Reader installed. You can find Acrobat Reader at www.adobe.com.

Send the completed form and dues to:

Membership Form
Eugene Natural History Society, Inc.
PO Box 3082, Eugene, OR 97403

ENHSMemApp.pdf

Annual dues for renewing members are payable in September. New members joining in midyear may pro-rate dues as appropriate. Generosity is encouraged.

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Membership Type:		Annual Dues Enclosed:
New Renewal	___ ___	Contributing ($15) Sustaining ($10) Regular ($7.50) Basic ($5) Life ($100)	___ ___ ___ ___ ___
Name __________________________________________________ Address ________________________________________________ City ____________________________ State ____ Zip _________ Phone ___________________________
Providing the following information is voluntary, but appreciated:
Interests:
___ Archaeology ___ Astronomy ___ Bird Study ___ Botany ___ Conservation	___ Geology ___ History of Science ___ Herpetology ___ Meteorology ___ Mosses and Lichens	___ Mushrooms ___ Nature Walks ___ Wildflowers ___ Zoology
___ Other ______________________________________________
Would you like to:
___ Lead field trips ___ Teach informal classes ___ Work on committees
What would you like to hear a talk on? ______________________________________________________ Do you have special experience in natural history? ______________________________________________________