Friends of Nekhen Membership Form

Name

Address

City

E-mail address

State/Province

Postal/Zip Code

Country

The membership category I prefer is:

Regular ($25/£17) Patron ($500/£250) Student ($20/ £12)
Sponsor ($250/£150) Sustaining ($1000/£500)  

This is a renewal (if you've already renewed, thank you)


Gift (choose a category above and mark with "G")  
Gift from:  

A card will be sent to the recipient if you wish:

Yes, I want a cards sent No, do not send a card.

Fill in recipients name/address in space provided above.

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