Friends of the Hartland Public Library
Membership Form
Name(s): ______________________________________________________________
Membership Level
Friend ($10.00 per year*) ___________
Supporting Member ($25.00 per year*) ___________
Lifetime ($100.00 one time) ___________
Street Address: _________________________ Phone: ______________________
Town and Zip: _________________________ Email: _______________________
Are there ways in which you would like to help contribute to the library (volunteering for desk/shelf work, board membership, fundraising, etc.)? Please indicate below:
*Please note: Membership dues run from January 1 – December 31 each year. Dues in the first year of membership are not prorated.
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To be completed by Recipient:
Date received: _________________________________
Received by: ___________________________________________________________
Date deposited: ________________________________