Friends of the Libraries Application to Join

Please complete this form, print, and sign it if paying by credit card.

I would love to become a Friend, at the membership level checked below.

$ 20 Student Supporter

$ 40 Senior Citizen (65 years)

$ 60 Individual Membership

$ 75 Joint Membership

$ 150 Supporter

$ 500 Benefactor

$1,000 Patron

Other Amount

Please contact me at about my gift of books, manuscripts or other Library materials.

Name:

Address:

City, State, Zip:

Please add my name to the Friends' electronic mailing list. My preferred e-mail address is:

Kindly indicate payment method:

I would like to make my gift by cash/check
(Make check payable to the Binghamton University Foundation in the amount indicated above.)

I would like to make my gift by credit card (check one):

Visa MasterCard American Express Discover

Card Number:

Card Expiration: Month Year

Signature:

CID Code (last three digits on back of signature panel, or first four digits on front of AMEX card):

I am a graduate of Binghamton University.

My company has a matching gift program.

Please send additional information about making a gift to the University Libraries.

Please mail form to

John M. Meador, Jr.
Director of Libraries
University Libraries
Binghamton University
P.O. Box 6012
Binghamton, New York 13902-6012