Yes! I would like to become a member of the Friends of Lyndhurst!

Name:_______________________________________________________
Address:______________________________________________________
City: _____________________________________________
State______________________________
Zip: _______________ Phone: _______________

E-mail: ___________________________________

Please Select Category of Membership:
(See Membership page for category benefits.)
__  Individual or Senior   $35
__  Family   $55
__  Contributing   $100
__  Sustaining   $250
__  Benefactor   $500
__  Tower Society   $1000

This is a:
__  New membership    __  Renewal

__  I would like to give a gift membership
            Please Select Category of Gift Membership:
                (See Membership page for category benefits.)
            __  Individual or Senior   $35
            __  Family   $55
            __  Contributing   $100
            __  Sustaining   $250
            __  Benefactor   $500
            __  Tower Society   $1000

          Send this gift membership to:
            Name:_______________________________________________________
            Address:______________________________________________________
            City: _____________________________________________
            State______________________________
            Zip: _______________ Phone: _______________

           Message for gift card:
            _____________________________________________________________

Enclosed Please Find:
Membership Dues:     $_______________
Additional Donation: $_______________
Gift Membership        $_______________
TOTAL                         $_______________

Make a Match
__  I am enclosing a matching donation form
Many employers offer a matching donation program for employee charitible contributions.
If your organization has a matching gift program, please forward the appropriate company
form to Lyndhurst with this form and your check. We will be happy to assist you.