Enclosed is my contribution for:
     $15 Student/Senior*
     $25 Individual*
     $50 Supporting*
     $100 Contributing* ($100 members receive an Eco-Cycle T-shirt.)
     $500 Contributing* ($500 members receive an Eco-Cycle T-shirt and a tote bag.)
     Other: $___________*
*All members will receive a bumper sticker and a subscription to the Eco-Cycle Times.
Thank you, but I do not wish to receive a premium for my membership contribution.

Payment Method: Visa MasterCard Check enclosed

Card no._______________________________Exp. Date________

Signature_______________________________________________

I would like to apply for an Eco-Cycle Master Card or Visa.
I would like to invest in the future of recycling by remembering Eco-Cycle in my will. Please call me.

Please send me more information about:
Becoming an Eco-Cycle volunteer at the Drop-off Center or a Block Leader for my neighborhood.
Having my business join Eco-Cycle’s Waste Reduction Program for businesses.
Joining Eco-Cycle’s Voluntary Simplicity and Deep Ecology Circles.
I would like to contribute through payroll deduction. My workplace is _________________________.
  
Eco-Cycle is a Community Shares Agency. If your office does not have a Community Shares program, but does have a United Way program, ask for the form for non-United Way agencies and write in “Eco-Cycle.”

Name ________________________________________________________________________

Address ______________________________________________________________________

City _______________________________ 

State _______ Zip Code ____________________

Phone (Day) ____________________________ 

Phone (Evening) ____________________________

Thank you for your support. All contributions are tax-deductible, minus the value of premiums received. Eco-Cycle does not give or sell member names and addresses to other organizations. Please make your check payable to Eco-Cycle and return it with this form to: Eco-Cycle, P.O. Box 19006, Boulder, CO 80308.