MEMBERSHIP AND DONATION FORM

Name ____________________ Spouse________________

Address ______________________________

City ______________________State ______

Zip __________ Phone _________________

SFA of CM Membership-Family/year $20.00 

Date _______________Check # __________

Renew _____       New ______

Additional Contribution $_____________

(Tax deductible to the extent of law)

Date _______________Check # __________

Total Amount Enclosed $ _____________

Signature ____________________________________________

Mail this form to:

Ken Sanders

PO Box 506

Wadena, MN 56482

Or call (320) 355-2980