foundation@tileheritage.org
Annual Memberships:
Individuals and Families: Business Memberships:
____$ 45. Regular ____$ 100. Centurian*
____$ 60. Supporting ____$ 250. Sponsor
____$ 75. Sustaining ____$ 500. Donor
____$ 150. Friend ____$1000. Benefactor
____$ 300. Guardian
____$ 500. Patron ____$ 50. Outside U.S.
All contributions are tax-deductible to the full extent allowed by law.
Name:______________________________________________
Company:____________________________________________
Address:_____________________________________________
City:_________________________ State:______ Zip:_________
Phone:______________________ Fax:_____________________
E-mail:______________________________________________
www._________________________________________________
*____ I contribute $100 or more each year. Please link my website to Tile Heritage.
Make check payable to "Tile Heritage Foundation" and mail to Tile Heritage, P. O. Box 1850, Healdsburg, CA 95448
or fax this form with your credit card number to 707 431-8455. Do not email your credit card number.
Charge my Mastercard or Visa: $________
________/________/________/________ Exp.________
__________________________________________
Signature
List my Occupation or Affiliation as
_________________________________
in the THF Resource Directory.
______ Please send information on Doty Research Grant.