Membership Application for Seattle Atheists

 

Becoming a member of the Seattle Atheists is not only a way to interact with fellow atheists. It also makes a statement that you are willing to stand up for individual and intellectual freedom and contribute to the efforts of the atheist community.

 

Name(s): _________________________________________________________________

 

Address:__________________________________________________________________

 

City:____________________  State:____________________ Zip:____________________

 

Telephone: (____)__________________ Email: __________________________________

 

*Note: Your personal information will be kept strictly confidential. 

 

Please indicate which type of membership you prefer:

 

[ ]  Individual   $25                                    [ ] Student/Senior  $15

[ ]  Household  $35                                    [ ] Lifetime $250

 

To make an additional donation to Seattle Atheists beyond your membership dues, please indicate where you would like to have those funds directed:

 

[ ]  General Fund               [ ]  Building Fund

[ ]  Legal Fund                   [ ]  Speaker Fund

 

Total amount enclosed: _______________________

 

May we ask how you heard about Seattle Atheists?

 

[ ]  Friend               [ ] Yahoo Group                     [ ] A website: ___________________

[ ]  Meetup.com     [ ] Print Ad: ______________  [ ] Other: _____________________

 

Signature: _____________________________________  Date:_____________

 

Return this form to: Seattle Atheists. 11008 NE 140th St  Kirkland, WA 98034

 

You may also hand-deliver your application and dues to Seattle Atheists treasurer Jerry Schiffelbein or another board member at any group event.  Jerry can be reached at jerry.schiffelbein@seattleatheists.org.

 

Because Seattle Atheists is a not-for-profit organization, annual membership dues and any additional donations are tax deductible.  Just ask for a receipt.

 

Thank you for your support of Seattle Atheists!