To join the Friends of the Cora J. Belden Library, print and fill out this form; then, mail the form and your check to the address below. All dues are used to benefit the library.

Thank you for your support.

FRIENDS OF THE CORA J. BELDEN LIBRARY

Check one:

q Household_______ $10          Name: _______________________

q Sponsor_________ $25          Street: _______________________

q Patron__________ $50          Town: ______________ State: ____

q Life____________ $200         Zip: _________

q Business________ $75

q Yes, I would like to be an active member in _____ Volunteer Activities, _____ Fundraising Events, _____ Membership Committee

Email: __________________________________________

Please make your tax-deductible check payable to :

Friends of the Cora J. Belden Library

33 Church Street
Rocky Hill, CT 06067-1568