Logo: Vegetarians of Washington
                    Membership Form

Via Post: Print this form, fill out, and mail with payment (check or credit card) to:

Vegetarians of Washington
15100 SE 38th St - #820
Bellevue, WA 98006

Via Fax: Print this form, fill out, and fax to 425.603.0813 (credit card payment only).


I/We wish to join Vegetarians of Washington. I/We enclose:
I/We wish to renew our membership with Vegetarians of Washington. I/We enclose:

$22 (Individual)      $35 (Family)      $50 (Supporter)      $100 (Patron)

Name(s):___________________________________________________________________

Address:___________________________________________________________________

__________________________________________________________________________

City:_____________________________________ State:______ Zip:__________________

Home Phone:_______________________ Work Phone:_________________________

E-mail(s):__________________________________________________________________


Do you wish to receive a free subscription to the Vegetarian Times?
         Yes    No
This will be sent to your address nine times per year.
We respect your privacy. We have ensured that your name and address will not be shared or used for any other purposes.


Paying by Check: Please make checks payable to: Vegetarians of Washington

Paying by Credit Card: Mastercard®      Visa®

Card #:_______________________________________________ Expires:___________

Zip code if different from above___________________________________________3-digit security code ____________

Signature:_____________________________________________ Today's Date:________________

Vegetarians of Washington are a 501(c)3 non-profit organization. We do not share your information with anyone else without your prior permission.