CNMA Printable Membership Form: Please mail or fax this form, or telephone us to join the CNMA.

CNMA
Colorado National Monument
Fruita, CO 81521

TelePhone: (970) 858-3617 ext. 308
Fax: (970) 858-0372
E-Mail: COLM_CNMA@nps.gov

I would like to join the CNMA at the following membership levels (check appropriate boxes):

Individual $20
Couple $25
Family $30
Contributing $100 - $199
Corporate/Patron $200 - $499
Benefactor $500 and up

New Membership

Renewal

Gift From: _____________________________

Additional Donation: ________________

Name___________________________________________________________________________

Address_________________________________________________________________________

City________________________________________ State_____________ Zip________________

Daytime Telephone (_____)_____________________

Method of Payment: Check ________ (please mail to CNMA with this form)

MC/Visa/Discover/American Express #_______________________________ Exp. Date_________

Total Charges___________________

Credit Card Holder Signature________________________________________________________

Thank you for joining us. Welcome to the CNMA!

Membership dues and other contributions are tax deductible to the extent provided by law.