Falls of the Ohio Membership Application

Membership level

___ PATRON ($200)*

___ SPONSOR ($100)*

___ ASSOCIATE ($50)

___ FRIEND ($25)

* Patron & Sponsor members, check for appropriate Indiana State Park pass

__ In-state (Indiana residents)             __ Out-of-state (non-Indiana residents)

__ Golden Hoosier (for Indiana residents over the age of 65)

____________________________________
Name as it should appear on membership card		    
____________________________________
Address 		   
____________________________________
City 		_______________
State 		_______________
Zip
____________________________________
Phone 		_______________
Date 		 

Please make check payable to the The Falls of the Ohio Foundation, Inc., or you may charge as follows:

____ Visa ____ MasterCard ____ Discover

____________________________________
Card # 		_______________
Expiration Date		  

Mail this form with payment to:
The Falls of the Ohio Foundation, Inc.
201 W. Riverside Dr.
Clarksville, IN 47129