Dan River Basin Association

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Membership Application

The Dan River Basin Association is a 501(c)(3) nonprofit organization. Memberships, donations, and gifts are fully tax-deductible.


Name:
Address:
City
State:
Zip Code:
Phone:
Email:

Membership category: (Choose one)
	Individual ($25)
	Family ($40)
	Organization ($50)*
	Corporate ($100)**
	Friend ($50)
	Steward ($100)
	Protector ($250)
	Benefactor ($500)
	Sponsor ($1000+)
	nonprofit organization or corporation having 10 or fewer members *corporation having more than 10 members

Corporate members join as Steward (or higher), and Organization members join as Friend (or higher). Each membership, in any category, is entitled to ONE vote.
I'm Interested in helping with: (Check all that apply)
	Boat Access (plan and maintain)
	Displays for Festivals and Museums (plan/staff booth)
	First Saturday & other outings (plan/lead)
	Fund Raising and/or Grant Proposal Writing
	Hiking, Biking, Riding, Portage Trails (plan/maintain)
	Hospitality and/or Office Support
	Programs for Meetings
	Publicity/ Correspondence

My name may be printed in the newsletter in my membership category.
	Yes No

Free DRBA Logo Decal (Check One):
	Boat Decal, 6.5" x 4"
	Window Decal, 4" x 2.5"
	No Decal, Please
	Additional decals cost $1.50 each and can be purchased from our DRBA Store at left.

Thank you for taking time to complete this form and joining the Dan River Basin Association family.

PAY BY CREDIT CARD
After you submit this application you will proceed to the payment section. Please click the appropriate Category Membership button.

PAY BY CHECK
If you don't wish to make your payment by credit card check the box below and make your check payable to the Dan River Basin Association and mail it to the address below.

I will be paying by check.

Dan River Basin Association
Suite 401, 413 Church St.
Eden, NC 27288
Phone: 336.627.6270

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Dan River Basin Association

Suite 401, 413 Church St. Eden, NC 27288 Phone: 336.627.6270 drba.nc@danriver.org	Henry County Administration Building PO Box 7 Collinsville, VA 24078 Phone: 276-634-2545 drba.va@danriver.org
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