Name
________________________________________
Are you a community or school gardener? Name of
Garden:
________________________________________
Address
________________________________________
City, State, Zip
________________________________________
E-mail
________________________________________
Daytime Tel
________________________________________
Check one:
New Member
Renewing Member
Additional Donation - I'm already a member
Donation Amount:
$20 community gardener, student or senior
$30 individual
$40 family, school, organization or business
Name:______________________________________________
$100 supporter
$300 sponsor
$500 sustainer
Other amount ______________________________________
Method of Payment:
Check (payable to Urban Harvest)
Master Card
Visa
Credit Card #_________________________Expiration Date__________
3-digit number on the back of your card_______
Urban Harvest
P.O. Box 980460
Houston, TX 77098-0460
Thank you for your generous contribution.
New members will receive a welcome packet of information.
Contributions are tax-deductible as allowable by law.