Hitchcock Center for the Environment, Amherst, MA


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Hitchcock Center Membership Form

Please Check One:

(   ) I would like to Join as a New Member
(   ) I would like to Renew my membership

Choose One of the Following:

_____ Senior /Student/ Teacher $15
_____ Individual  $30 
_____ Couple/Family    $40
_____ White Pine  $75
_____ Red Oak $100
_____ Larch Tree  $250

Name:      _________________________________________________
Address:  _________________________________________________
                _________________________________________________
Phone:     ___________________________

Please make check payable to: Hitchcock Center
                                OR
Charge my (  ) VISA or (  ) MASTERCARD Card Number________________________

Expiration Date_____________  Signature_______________________________________


Hitchcock Center, 525 South Pleasant Street, Amherst, MA 01002
Questions or comments?  E-mail us at hcenter@crocker.com