Amigos de Sian Ka'an

ANNUAL MEMBERSHIP APPLICATION FORM

Date: ______________________________________________________________
Name:________________________________________________________________________________________
Address:______________________________________________________________________________________
City: _______________________________________ State:__________________________________________
Country: ____________________________ Zip Code.: ____________ Phone.:____________________________
E-mail:_______________________________________________
¿How did you learn about us?:____________________________________________________________________
Yes,  I want to support Amigos de Sian Ka'an and their efforts to preserve and protect Quintana Roo's natural
heritage. I am enclosing a gift in US dollars of:
 
$
25 US
 
Member
Parrot
 
$
50 US
 
Family
Flamingo
 
$
100 US
 
Amigo
Manatee
 
$
250 US
 
Collaborator
Jabiru
 
$
500 US
 
Benefactor
Margay
 
$
1,000 US
 
Sponsor
Jaguar
 
I already sent my fee and want to make an additional contribution of: _____________________________________

Membership benefits:

Please make your check payable to:
Amigos de Sian Ka'an, A.C.
and mail to: Apartado Postal 770,
Cancún, Quintana Roo, 77500, México.

Donations of $100 dollars or more can be tax deductible in the USA.
In this case, make a check payable to:
"The Sian Ka'an Project of the FMDF" and mail to:
Friends of Mexican Development Foundation
67 A East 77th Street
New york, N.Y. 10021-1813
Phone (212) 737-1011