Evansville Literacy Coalition Membership Form

“Never doubt that a small group of committed

Citizens can change the world.

Indeed it is the only thing that ever has.”

Margaret Mead

~Your Commitment~

Membership Form

I understand the critical need for continued support of the Evansville Literacy Coalition.  Here is my membership fee for ___ /___ /_____to ___ /____ /____.

Annual Fee - - - - - - - - - - - - - - - - - - - - - - -  $25.00

Additional Contribution  - - - - - - - - - - - - - -  ______

Total   - - - - - - - -- - - - - - - - - - - - - - - - - (             )

Checks made payable to ~ Evansville Literacy Coalition

Remit to:   ELC
                5413 Fielding Manor Drive

                Evansville, IN 47715

Name____________________________________________________

Address__________________________________________________

City_____________________________________________________

State/Zip_________________________________________________

Organization________________________________________ 

Phone_______________Email______________________ 

Download Form:  https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0BwGKzGsd1tLTZmM3OWYyN2YtMzgxYi00Y2Q5LThjNzgtOGIwM2ZjM2RmYmYy&hl=en_US