Membership Application

If we are to meet the needs for Alabama's Environment, we must have your help.  Print out this page, with the completed form, and mail to:

AlaLEAVs
P.O. Box 1987
Montgomery, AL  36102-1987

Click here to download the membership application as PDF:
Membership Application

Name (First/MI/Last):

Mailing Address:

City, State, Zip:

Phone (Area/Prefix/Suffix):

FAX (Area/Prefix/Suffix):

Email:

Club Level (Select One):

Golden LEAVs	$1000
Orange LEAVs	$500
Yellow LEAVs	$250
Green LEAVs	$100
Member	$30
Students	$15

Amount Enclosed:

Bill Me:

Special Environmental Interest of Clubs:

I'll volunteer:

Enclosed are names:

My State Senator is:

My State Representative is: