THE SCOTT ARBORETUM OF SWARTHMORE COLLEGE

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Printable Membership Application

Select your membership category to join online or

Print this form and mail to:
Scott Arboretum — 500 College Ave. — Swarthmore, PA 19081

Full names of all covered by membership:

_______________________________________________________

_______________________________________________________

Name(s) as you wish it to appear in our records:

_______________________________________________________

Address ________________________________________________

City ________________________ State ________ Zip ___________

Phone (day) ___________________ (evening) _________________

E-mail __________________________________________________

Today's Date ____________________________________________

Please indicate the membership category you've selected:
  $10 College Student (copy of id required)
  $40 Individual
  $55 Dual
  $75 Contributor
  $150 Sponsor
  $250 Benefactor
  $500 Patron
  $1000 Director's Circle
  $3000 Philanthropist
  $125 Organization
Payment Method

__ Check enclosed (Payable to the Associates of the Scott Arboretum)

__ Visa credit card   __ Mastercard

Credit Card #: _______________________ Expiration Date ________

Cardholder's Name ________________________________________

Signature ________________________________________________

Matching Gifts

If you work for a matching company, please submit a matching gift form.

Additional Contribution

I would like to make an additional contribution of $_________.
Please make a separate check payable to the Scott Arboretum.

Gift Memberships

If this is a gift membership please include:

Donor's Name ___________________________________________

Address ________________________________________________

City ________________________ State ________ Zip ___________

E-mail __________________________________________________