Membership Application
Become A Member
of
Keep Charlotte Beautiful
Name
Address
City, State
and Zip Code
Phone #
Email Address
Level of
Membership
Annual Dues         
Student....................  $2.00
Individual.................. $15.00
Family...................... $25.00
Business.................. $100.00
Patron.......................$500.00
Benefactor................$1000.00
Star Benefactor........$5000.00 and up
Please accept my tax-exempt donation in the amount of:
I am interested in Volunteering
for the following programs!
Board of Directors
Great American Cleanup
Committee Member
Coastal Cleanup
Litter Abatement
Committee
Adopt-A-Road
Fund Raising
Committee
Adopt-A-Shore
Beautification
Projects
Adopt-A-Highway
Student Calendar
Art Contest
Thank you for your donation!
Please Print and send form to:  Keep Charlotte Beautiful, Inc.
                       25550 Harbor View Road, Suite 2
                       Port Charlotte, Fl 33980

Any questions please call Glenda Anderson at 941-764-4390
Keep Charlotte Beautiful, Inc., is a private, non-profit, 501(c)(3) corporation
established in 2001 as an affiliate of Keep America Beautiful, Inc.