Yes, I would like to support KBFPC with a membership contribution of:

                      ___$25 contributing                             ___$50 supporting

                      ___$75 sustaining                                ___$100 invigorating

                     ___$500 or MORE...Outstanding!       ___ Please check if you would like to be put on a list of

                                                                                        potential volunteers we can call.

NAME_________________________________________________________________________

ADDRESS______________________________________________________________________

PHONE________________________(optional)  EMAIL________________________________(optional)

be sure to include your email address so that you can receive our electronic newsletter

      ____My check to KBPFC is enclosed      OR      ____Please charge my Visa/Mastercard/AMEX/Discover

Card No:____________________________________________Expiration Date_________________

Signature____________________________________________

PLEASE PRINT AND MAIL YOUR FORM WITH YOUR CHECK OR CREDIT CARD NUMBER TO KBPFC--3959 Ben Walters Lane, Homer, Alaska  99603.

OR YOU CAN DONATE TO KBPFC DIRECTLY ONLINE AT CHANGE.ORG