OPAS Membership Application                                                             NAS Code Y087XCH

Date:___________________

Let OPAS be your one-stop Audubon membership initiator. Please print this form, then check one of the two options below. Mail payment with this form to Olympic Peninsula Audubon Society, P.O. Box 502, Sequim, WA 98382.

___ Local OPAS Membership, includes subscription to the Harlequin Happenings bi-monthly newsletter: $20.00.
___ Combined Local OPAS and National Audubon Society Membership, includes subscriptions to Harlequin Happenings & Audubon Magazine: $40.00 initial membership; $35.00 initial membership for seniors (over age 61) and students. Subsequent renewals of National Audubon Society memberships should be arranged directly with National Audubon Society.

Name_____________________________________ Phone _________________

Street___________________________________________________________

City State Zip___________________________________________________

E-Mail (for electronic HH delivery)___________________________________

Oer age 61? Yes No (Circle One)

Payment by check:
         Please make your check for $20.00 payable to OPAS

Payment by credit card:
         Master Card or Visa (circle one):
         Card Number_______________________ Expiration Date____________

Authorized Signature__________________________________________

□ Check this box if you would like to be contacted concerning volunteer opportunities at OPAS or the Dungeness River Audubon Center