Donor Form
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Count Me As A Steward of the Potomac Highlands!
Name ________________________________________________________
Street ______________________________________________________
City __________________________ State ____ Zip ______________
Phone _______________________________________________________
Email/Web Site ______________________________________________
Talents/Expertise ___________________________________________
_____________________________________________________________
Areas of greatest concern: __________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
$25 $50 $100 $250 $500 $ _____
Please circle the amount of your donation (any amount is appreciated!) and mail to:
Stewards of the Potomac Highlands
PO Box 455
Wardensville, WV 26851-0455
Because we are an advocacy group and exercise our rights to lobby to protect our Potomac Highlands your contribution is not tax deductible. Tax deductible donations in amounts of $100 or more can be made out to Friends of the Earth and mailed to our address. Please use the back of this form to send names and addresses of others who may be interested in joining, or if you need more room for your specific ideas and concerns.