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MEMBERSHIP APPLICATION

Friends of the Columbia County Public Library

___ I want to continue my membership in the FRIENDS.

___ I want to become a member of the FRIENDS.

___ Individual              $    5.00

___ Family                   $  10.00

___ Organization          $  25.00

___ Sustaining Donor   $   50.00

___ Sponsor                $ 100.00

___ Contributing          $ ______

___ Literacy Donation   $ ______

Name ____________________________________

Name ____________________________________

Name ____________________________________

Name ____________________________________

Address  __________________________________

City __________________ State ____ Zip _______

Telephone  ________________________________

Email _____________________________________

• Dues and contributions are tax deductible.

A copy of the official registration (#CH05830) and financial information may be obtained from the Division of Consumer Services by calling toll-free 1-800-HELP-FLA (435-7352) within the state or online at www.FloridaConsumerHelp.com.  Registration does not imply endorsement, approval, or recommendation by the state.  This organization retains 100% of all contributions received. 

Please make checks payable to:

Friends of the Columbia County Public Library

308 NW Columbia Avenue

Lake City, Florida 32055

(386) 758-1018

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