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Membership levels:

___Hellbender $500
___Spotfin Chub $250
___Appalachian Elktoe $100
___Sicklefin Redhorse $50

___Sculpin $35
___Tennessee Shiner $25
___Other $____________


Please accept this gift and notify the following:

___in memory of
___in honor of

Name:_____________________
Address:___________________
__________________________

I would like to learn more about:

___Arranging a matching gift from my employer
___Making a gift of stock
___Other giving options, such as bequests
___Becoming an LTWA volunteer


Name_____________________________________
Address___________________________________
_________________________________________
City___________________State____Zip_________
Email_____________________________________
Home Phone_____________________________________

LTWA is a 501c3 nonprofit organization. Contributions are tax deductible.

Please make checks payable to LTWA.

Please print this form and mail it to:
LTWA
16 Stewart St.
Franklin, NC 28734

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