Friends of the Mishawaka-Penn-Harris Public Library Membership Application Form
Instructions: Print this page, fill out form, and mail to:
Friends of the Mishawaka-Penn-Harris Public Library
Membership Application Form
Instructions: Print this page, fill out form, and mail to:
Friends of the Library
209 Lincoln Way East
Mishawaka, IN 46544
The application and fee may also be dropped off at any Mishawaka-Penn-Harris Public Library location.
Name:_________________________________________________________________
Address _______________________________________________________________
City: ______________________State:_________________ Zip Code: _____________
Phone: home _________________ work ________________
Email: ______________________________________
Please check one:
New _____ Renewal _____ Gift membership _____ From: ________________________
Please check one:
Individual: One year $7.00 _____ Three years $14.00 _____
Family: One year $10.00 _____ Three years $22.00 _____
Junior (Grades K-12): One year $1.00 _____
Life Member: $100.00 _____
Additional Donation (Tax deductible): $ _____
Please make check payable to the Friends of the Mishawaka-Penn-Harris Public Library.Please check one:
I would like to volunteer for the Friends of the Library. _____
I would like to volunteer at the library. _____
Date ____________ Signed _____________________________________________