MEEA ANNUAL MEMBERSHIP APPLICATION
for the fiscal year July 1, 2004-June 30, 2005

Items in bold are required.

 Name of Individual or Organization:

Contact person: First Name:  Last Name:

Job Title:

 Address:

 City: State: Zip:

 Phone:   Fax:

 Email:

 Website URL:

FEES:

The minimum fee is $25 for organizations & agencies, $10 for individuals.
(Higher contributions are always welcome.)
Please check your appropriate category:

If payment cannot be made now, please indicate the month in which
it will be made: 

Please check here if a scholarship is requested.

Notes:

MEEA Membership fees support the marketing and recruiting efforts of MEEA
members acting as a collaborative.

Thank you!

Before clicking the SUBMIT button, please print out this application; attach member fee made payable to the fiduciary agent, Environmental Volunteers, and mail to:

Environmental Volunteers
MEEA Membership
3921 E. Bayshore Road
Palo Alto  CA  94303

650/961-0545 -- fax 650/961-0548
info@EVols.org -- www.EVols.org

Membership is not official until payment is received.

Thank you.