___ New Member ___ Renewing Member
___ $10 Student / Other*
___ $50 Member (Individual / Family)
___ $100 Patron
___ $150 Clubs/Organizations
___ $250 Sustainer
___ $500 Benefactor
___ $1000 Life Membership
___ $5000 Preservationist**
___ Gift in any amount:___________
* Student / Other low-income
** Preservationist includes Life Membership & 2 complimentary tickets to the Annual Luncheon
Your Name________________________________________ Phone______________ Address______________________________________________________________ City_____________________________________ State______ Zip____________E-mail us:
Write your check to the Committee of One Hundred & send this form and check to:
Committee of One Hundred
Balboa Park Administration Building
2125 Park Blvd.
San Diego, CA 92101-4753
