Contributing Business Member Agreement

Individual Member Agreement
Name*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Contribution Levels

$10,000 and above ... Leaving a Legacy*

$5,000 or more ... Making an Impact on Evergreen's Future**

$2,500 or more ... Investing in the Future of Evergreen**

$1,000 or more ... Sustaining the Look and Feel of Evergreen**

$10 to $999 ... For the Love of Evergreen**

* Your name will be listed on our website in perpetuity
** Your name will be listed on our website while your membership is current
MY PREFERENCE IS TO (choose one)
Donate one time only for $ blank*(by check or online).
Donate $ blank* on a monthly recurring basis online through PayPal or my credit card (you must complete the process online).
Please tell us why you feel it is important to be a member of the Evergreen Legacy Fund. NOTE: We may use this quote for promotions as well as post it on our website and include in other media materials.
SIGNATURE (type name and date)*
Should be Empty:

Individual Member Agreement