Friends of the CCBC Membership Form

To join the Friends of the CCBC, print and fill out this form and send to the Friends (address below).

Either individual or group memberships are available. If you have questions about the types or benefits of membership, please contact Linda Schmitt, Membership Secretary of the Friends.

The membership year is January through December. Dues paid after October 1st each year apply to membership for the next year. Your membership is tax deductible to the fullest extent of the law.

Individual Membership: ___ New Member ___Renewal ___Gift

Please check the Individual membership level you are joining/renewing at:

___ $9 Student ___$20 Personal ___$30 Sustaining ___ $50 Supporting ___ $100 Patron

Group Membership: ___ New Member ___Renewal ___Gift

Please check the Group membership level you are joining/renewing at:

___ $75 Honor Level (2-5 individuals) ___ $150 Award Level (6-10 individuals)
___$250 Distinguished Level (11-15 individuals) ___$500+ Corporate Level

Gift memberships: please designate who you would like acknowledged as the giver on the gift card:

_________________________________________________________________

Membership information:

Name: _________________________________________________________________

Position:________________________________________________________________

Address:_______________________________________________________________

City: _________________________________ State: _____ Zipcode:__________

Telephone: (w) ________________________ (h) ___________________________

e-mail:___________________________________

Make check payable to the Friends of the CCBC, Inc.
Mail to: Treasurer, Friends of the CCBC, Inc., Box 5189, Madison, WI 53705