Membership Form

Thank you for taking the time to mail in

this form and for you generous support!

Your Information

Full Name(s) (First, Last) ____________________________________________________________

Address __________________________________________________________________________

Address 2 ________________________________________________________________________

City _______________________________   State/Province  _______________________________

State __________________________  Zip Code ___________________________

Phone __________________________  Fax _______________________________

Email ___________________________  Email 2 ____________________________

I have included a check or money order for the amount of __________________.

Please make checks or money orders payable to: Crater Lake Institute

Please mail this form to: Crater Lake Institute P.O. Box 2 Crater Lake, Oregon 97602   Thank you!