Dharma Field Membership: Mail-in Registration Form
Type information into empty fields and click appropriate check boxes.
Name
Address
City       State       Zip
Daytime phone     Evening phone
E-mail
Please do not list in member directory.
Paid Monthly
Paid Quarterly
Paid Yearly*
SUPPORTING Annual Pledge: Single
$33
$99
$395
SUPPORTING Annual Pledge: Family
$50
$150
$600
PARTICIPATING Annual Pledge
Participating Membership is for those living outside the metro area, namely, telephone area codes outside of 612, 651, 763, and 952.
$17
$50
$200
CONTRIBUTING Annual Pledge
Monthly
Quarterly
Yearly
For those who may not at present have the means to support full membership pledge. Enter amount you can contribute in the payment area here.
$
  I would like to pledge an additional contribution of $ per month to help with expenses. (This contribution is 100% tax deductible.)
  Enclosed is an additional contribution of $ to help with expenses.
(This contribution is 100% tax deductible.)
  Enclosed is an additional contribution of $ to the endowment fund.
(This contribution is 100% tax deductible.)
* A membership year runs from January through December. If you begin your membership after January and want to pay for the remainder of the year at once, please multiply the monthly rate by the number of months left in this calendar year. Membership renewal requests will be sent to you in December.
Total payment enclosed $
Membership dues and audio subscriptions are partially tax deductible and are not refundable.
Print this form and send with your check to: Dharma Field
3118 W 49 St
Minneapolis MN 55410