Friends of the Northfield Public Library Membership Form

Name(s)__________________________________________________
Address _________________________________________________
Phone (day) __________________(evening)__________________
E-Mail Address __________________________________________

Membership Category

__ Lifetime(Family)	$250
__ Lifetime(Individual)	150
__ Business	50
__ Family	25
__ Individual	15
__ Senior Citizen	10
__ Student	10

__ I am enclosing a check for $_____ to cover the membership
category checked above.
__ In addition, I am including a contribution of $_____.
__ My employer matches employee contributions.
Make checks payable to Friends of the Northfield Public Library.

Mail to:
Friends of the Northfield Public Library
210 Washingon Street
Northfield, MN 55057

Thank You!