Athens Conservancy MembershipName: _____________________________________________________
Telephone: _____________________ Email: ______________________
Business or Organization: _________________________________
Address: __________________________________________________
City/State/Zip: ___________________________________________
County: ___________________________________________________
Amount Enclosed: ___ $10.00 Basic Membership $_______ Additional donation
Optional: Please select one or more of the following interest areas that you're interested in:
___ Education
___ Fundraising
___ Publicity
___ Land research
___ Other (specify)_________________________