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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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