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Maine Chapter

To explore, enjoy, and protect the wild places of the earth

44 Oak St, Suite 301, Portland ME 04101 (207) 761-5616

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To mail in your membership form, just print a copy of this form and send it to the address below. By including reference number F99QE59001, more of your contribution stays in Maine.

The Sierra Club

Membership Services
P.O. Box 52968
Boulder, CO 80322-2968

Please fill out the information below:

First Name:
Last Name:
Address:
City:
State:
Zip:	-
Phone:
Fax:
Email:

May we correspond with you via e-mail?

Yes No

From time to time, we make our mailing list available to other worthy organizations. If you you do not want your name available to other worthy organizations, please check here.

Please select a membership level:

	Individual	Joint
Introductory	$25
Regular	$39	$49
Supporting	$75	$100
Contributing	$150	$175
Life	$1000	$1250
Student	$25	$35
Senior	$25	$35
Limited Income	$25	$35

Would you like to make an additional gift to the Sierra Club?
$

*Please select a payment method:

	VISA
	AMEX
	MasterCard
	Sierra Club MasterCard To apply for a Sierra Club MasterCard, call 1-800-932-2775.


Your Credit Card Number:* (no dashes or spaces please)
Expiration Date (mm/yy):*
Name on Credit Card:*

Please do not send me the free Expedition Pack. I prefer that all of my contribution goes towards protecting America's environment.

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Maine Chapter Reference: F99QE59001

Contributions, gifts and dues to the Sierra Club are not tax deductible; they support our effective, citizen-based advocacy and lobbying efforts. Your dues include $7.50 for your subscription to Sierra Magazine and $1 for your Chapter newsletter.

Questions or comments about this web site?

Please contact maine.chapter@sierraclub.org