Name ______________________________________________________
Business/Organization _________________________________________
Address_____________________________________________________
City ___________________ State ____________ Zip Code ___________
Phone __________________________ FAX ________________________
Cellular _________________________ Email _______________________
Website Address _____________________________________________
Student (enrolled in school) $15
Individual $25
Associate Restoration Partner
and/or nonprofit organization $100-999
Corporate $250
Lifetime Restoration Partner $1,000 and above
Lifetime Restoration Partners,
Please indicate if you would like to be recognized on a specific project.
Yes, I would like to be recognized on a specific project.
Please contact me to discuss the current projects. _______
No, I do not wish to be recognized on a specific project. _______
____________________________________
Please print a copy of this form and send it, along with
your membership fee to:
Eastern Nevada Landscape Coalition
P.O. Box 150266
Ely, Nevada 89315
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Membership Levels:
Eastern Nevada Landscape Coalition
Eastern Nevada Landscape Coalition
Become an ENLC Member