Santa Clara Bird Club

Show Division Sponsor Mail-in Form

- PLEASE PRINT ALL INFO-

Date_________________

First and Last Name ___________________________________________________

Address ____________________________________________________________

City _________________________________ ST__________  Zip_______________

Daytime phone# (__________)________________________________________

Email address______________________________________________________

Donation Amount Enclosed

$______________________________ for_________________________   Division

please write a division name or "general" for misc support of the Show

Mail this completed form by October 1st with your payment

by check or money order payable to

Santa Clara Bird Club / SCVCEBC

PO Box 3466

Santa Clara CA 95055-3466

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