Please print this page, complete the form, and return it with a check, or credit card number and signature to:
Mendocino Coast Botanical Gardens
18220 North Highway One
Fort Bragg, CA 95437
Membership Name:_____________________________________________________________________
Address:_____________________________________________________________________________
City:_________________________________________ State: ________ Zip:__________________
Telephone (day): ________________________ Email address: ____________________________
Business's Website Address: http://__________________________________________________
Please enroll me at the following Business Membership level (check one):
___ Business Member - $100
___ Business Sponsor - $150
___ Business Supporter - $250
___ Business Contributor - $500
___ Business Patron - $1000
___ Business Benefactor - $2500
___ Donation - $__________
Please list the two adults to be included in this Business Membership:
____________________________________________________________________________________
____________________________________________________________________________________
Charge my (circle one):
Visa MasterCard Discover
Full Name ____________________________________
Card # ______________________
Expiration Date: ___/___/___
Signature ______________________