MEMBERSHIP dues are $25.00, good until Dec. 31, 2010
 

NAME: (Please Print)___________________________________________

ADDRESS:____________________________________________________

CITY/TOWN:_______________STATE:__________ZIP:________________

CHECK NO._________FOR $:_______ADD’L DONATION:_______________

OCCUPATION:_________________________________________________

SPECIAL INTERESTS:____________________________________________

_____________________________________________________________

Would you like to volunteer  your time and skills?____________________

Have you worked at Camp Evans?  __________  When? ______________

Email: _______________________________________________________

Phone: ______________________________________________________

Please make all checks payable to: InfoAge Learning Center

Mail form to:
The Membership Director
Infoage Learning Center, 2201 Marconi Road, Wall NJ 07719.

The Information Age Learning Center is:
a tax-exempt and tax-deductible 501(c)(3) non-profit organization.
Donations are tax-deductible to the extent allowed by law.

Thank you very much!