Membership Form

Become a member of the B.A.R.K. Plus Chapter of the ACLU of Northern California and protect civil liberties. Print this page, fill it out, and mail it with your dues to:

The B.A.R.K. Plus Chapter of the ACLU of Northern CA
PO Box 11141
Berkeley, CA 94712

Name:   ____________________________________________

Address:___________________________________________

           ___________________________________________

Phone:  ___________________  FAX:  ___________________

Email, etc:__________________________________________

Enclosed are my non-deductable membership dues of:
         ___ $20     Individual member
         ___ $30    Joint member
         ___ $50    Contributing member
         ___ $125  Sponsoring member
made payable to the ACLU, for local ACLU lobbying efforts.

___ Here is my tax-deductible contribution,
        made payable to the ACLU FOUNDATION,
        for ACLU legal, public policy, and education programs.

___ Please send membership information to:

       _____________________________________________

       _____________________________________________

       _____________________________________________