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

                      ___$15 contributing                             ___$30 supporting

                      ___$60 sustaining                                ___$100 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)

      ____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.