join form

* denotes required fields

I am:   Applying for a NEW Membership
  Renewing my Membership
 

* Membership Level:

Student (18+)$5   Senior (55+)$5
Individual$10   Family$20
Patron$25   Sponsor$50
Benefactor$100 or more   Business$200 Minimum

My Contact Information:

*First Name
*Last Name
*Address (line1)
Address (line2)
*City
*State
*Zip Code
*Home Phone
Work Phone
Email Address
 

This is a gift membership for:

First Name
Last Name
Address (line1)
Address (line2)
City
State
Zip Code
Home Phone
Email Address
 
Will you help in one or more of the areas listed below?   Yes
  No
 
  Board Membership
  Business Sponsorship
  Fund Raising
  Grant Writing
  Publicity
  Book Sales - Sales
  Book Sales - Setup
  Book Sales - Sorting
  Technology (Web Site)

  

After completing the application, just CLICK the PRINT button.

Finally, mail the form along with your membership contribution to the address below.

Friends of the Kingman Library
PO Box 7000
Kingman, AZ 86402-7000

Please make check payable to Friends of the Kingman Library

Thank you for your interest and support!

Friends of the Mohave County Library at Kingman Copyright 2007-2011