Please complete the information below and mail to the address above along with your
check made payable to the Friends of Scioto Brush Creek, Inc.

Number of family members in household (if family) or employees (if business) ________

PLEASE ACCEPT MY ADDITIONAL DONATION OF $ _______________________

NAME _________________________________________________________________
       (Individual or business name as you would like it to appear on our membership list.)

ADDRESS ______________________________________________________________

CITY _______________________________ STATE ______________ ZIP _________

PHONE ___________________________

E-MAIL ________________________________________________________________

INTERESTS, TALENTS OR SKILLS THAT YOU MIGHT BRING TO THE GROUP:

______________________________________________________________________
 
PLEASE LET US KNOW YOUR SUGGESTIONS OR COMMENTS ON HOW WE MAY BETTER SERVE YOU AS A MEMBER:

“The mission of The Friends of Scioto Brush Creek, Inc. is to maintain and improve
the water quality of Scioto Brush Creek through education, awareness and
involvement of local residents.”
www.friendsofsciotobrushcreek.org