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i <br /> C_LTYCLUB <br /> i _ O F E U G E N E _ <br /> PO Box 12084, Eugene, OR-97440 <br /> 541.485.7433 * www.cityclubofeugene.org <br /> MEMBERSHIP FORM, <br /> ~ 2008-2009 <br /> Your Membership. lasts one calendar year. <br /> Yes! Uwe want to be a member of City Club of <br /> Eugene. <br /> New Membership Renewal <br /> SpOriSOr $500 Covers 2 members...you or yow business aze <br /> recognized in Newsletter, at Meeting <br /> ' Gold Sponsor $1000. <br /> Covers 4 members, you or yow business aze recognized in <br /> Newsletter & at Meeting. Plus: once a yeaz profile in newsletter & <br /> l one time a year a company table with 4 free lunches. <br /> I <br /> I <br /> Couple/Partner Membership $225 ff <br /> ~ Single Individual Membership $145 `1 ~ <br /> i <br /> ~ ~ Gold Membership $450 <br /> a Volunteer (15 hrs annually) $75 <br /> New Membership $75 <br /> Tax Deductible Contribution $ <br /> • Nam _ <br /> i <br /> Business ~ L~ <br /> Address ' <br /> <br /> i <br /> <br /> j ~ ~ City Ci rt,~ State Zip <br /> ~1(~ Phone: W ~ f ~ j' <br /> <br /> i C\.J \`~+v`' Email ~ t 6~~~ <br /> / ' Receive E-Newsletter Monthly <br /> Receive Mailed Newletter Monthly <br /> Check is enclosed for $ <br /> VIS <br /> A/M A ~ `t <br /> C ccount# ~ ~ 8a.~j <br /> Expiration Date <br /> ~J <br /> Signature <br /> <br />