GET “HOOKED”
JOIN THE BLUEFISH SOCIETY TODAY!
Please complete and return this form along with your annual gift to:
Bluefish Society ● UNCW Center for Marine Science ●5600 Marvin K. Moss Lane
Wilmington, NC 28409
Name ____________________________________________________
Address: _________________________________________________
City _________________________ State_________ Zip _________
E-mail ___________________________________________________
Daytime Phone: (
) ______________________________________
□ Yes, I want to join the Bluefish Society
□ $75 for an individual
□ $150 for a couple
□ $200 for a family membership
I am a:
□ New Member □ Renewing member
For couple or family membership, please list names below:
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
□ I know each dollar counts. Here is my additional contribution of $___________.
Payment method:
___ Check (Payable to UNCW)
____ Visa
___ MasterCard
Card Number ________________________ Exp. Date ____________
Name on card _____________________________________________
Signature _________________________________________________
I would like to pledge $_________ to be paid in _____ installments.
I would like to be billed: (check one)
___ Semi-annually
___ Quarterly ___ Monthly
My first payment of $______________ is enclosed.
How did you hear about the Bluefish Society? ____________________________________