WKKAHL MEMBERSHIP APPLICATION AND DONATION FORM

To become a member of the Friends of the W. K. Kellogg Arabian Horse Library, please fill out this page, print it out, and return with payment to:

W. K. Kellogg Arabian Horse Library
California State Polytechnic University, Pomona
3801 West Temple Avenue
Pomona, CA 91768
Phone: (909)869-3081 Fax: (909) 869-2129

Name__________________________________________________________
Address_______________________________________________________
City_________________________________________State____________
Zip/Postal Code_______________________________________________
Country_______________________________________________________
Email_________________________________________________________
Webpage_______________________________________________________

Membership :
___ Special Friend $100.00
___ Very Good Friend $50.00
___ Good Friend $25.00
___ Friend $15.00

Donation:
I wish to make a one-time donation in the
amount of ____________

Payment Method:
___ My check is enclosed. (Make checks payable to W. K. Kellogg Arabian Horse Library.)
___ Please bill my Visa. ___ Please bill my MasterCard.
Card Number _________________________________________________
Expiration Date _____________________________________________
Signature ___________________________________________________
Telephone ___________________________________________________