Name: ______________________________________

Address:_____________________________________

_____________________________________

Phone: ______________________________________

Email: ______________________________________

Do you wish to actively participate in projects?

____ yes ____ no

Membership Dues: (Please circle one)

• Student/Senior $2.00/year

• Individual $5.00/year

• Family $10.00/year

• Organization $25.00/year

• Contributing $50.00/year

• Life $100.00

Please print, complete and mail, along with dues, to:

Friends of the Library, Windsor Branch

7479 Metropolitan Blvd.

Barnhart, MO 63012