PRINT AND MAIL FORM
| INDIVIDUAL | $15 |
| FAMILY | $25 |
| SUSTAINING | $50 |
| CONTRIBUTING | $100 |
| PATRON | $250 |
| NON-PROFIT ORGANIZATION | $50 |
| COMMERCIAL ORGANIZATION | $100 |
| LIFETIME | 15 times any of the above |
I/WE WISH TO SUPPORT THE GOALS OF
THE NATIONAL WELSH-AMERICAN FOUNDATION
NAME__________________________________________________________________________
MAILING ADDRESS______________________________________________________________
PHONE (___) ___-_____
E-MAIL_________________________________________________________________________
WELSH CONNECTION____________________________________________________________
TYPE MEMBERSHIP_______________________________________________________________
ORGANIZATIONS:
URL_____________________________________________________________________________
POC_____________________________________________________________________________
Method of Payment: Check or Money Order $__________________