Membership Form

2012
Red fields are required.

Name

Mailing Address

City/Zip

Preferred Phone (optional)

E-mail

Check here if you do not wish to receive broadcast email from AAYC

Choose your membership category:
 Individual: $35
Family: $50
 Business/Organization: $50
Friend: $36 - 49
Advocate: $50 - 99
Patron: $100 - 249
Benefactor: $250 - 499
Sponsor: $500 - 999
Hero: $1000 - and above

Please bill me: enter amount
I'll be sending payment by mail: enter amount
If sending payment by mail, please include "AAYC membership" on your check
and mail to: AAYC, PO Box 898, McMinnville, Oregon, 97128